Fred Ignacio Mata Jr.
Counselor in San Jose, CA. Individual provider (NPI-1).
NPI number1720249295
StatusActive
Last updated in NPPESJun 18, 2008
Details
- NPI
- 1720249295
- Entity type
- Individual (NPI-1)
- Name
- Mr. Fred Ignacio Mata Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 18, 2008
- Last updated
- Jun 18, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
1885 Lundy AveSte 223
San Jose, CA 95131-1887
Phone 408-503-7960
Mailing address
1885 Lundy AveSte 223
San Jose, CA 95131-1887
Phone 408-503-7960
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