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ANDREW RAVORN BY

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1891975744

Individual Registrant:
 ANDREW RAVORN BY 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1904 RICHLAND AVE  CERES, CA 95307-4562 US
Tel: 209-541-2121  Fax: --

Contact information for business:
500 N 9TH ST STE A  MODESTO, CA 95350-5814 US
Tel: 209-558-4598  Fax: --

Registration Information:
NPI: 1891975744
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CLINICALSERVICETECHNICIAN374700000X01




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