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Charlene Conway, LPT

Licensed Psychiatric Technician in Fairfield, CA. Individual provider (NPI-1).

NPI number1770018962
StatusActive
Last updated in NPPESApr 25, 2017

Details

NPI
1770018962
Entity type
Individual (NPI-1)
Name
Charlene Conway
Credential
LPT
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 25, 2017
Last updated
Apr 25, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
167G00000X Licensed Psychiatric Technician40381CAYes

Practice location

2101 Courage Dr
Fairfield, CA 94533-6717

Phone 707-639-4675

Mailing address

2101 Courage Dr
Fairfield, CA 94533-6717

Phone 707-639-4675

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