Organization · Type 2 NPI
Matthew Fava
Mental Health Clinic/Center (Including Community Mental Health Center) · Lodi, CA
NPI number
1821117284
Active
Practice location
404 W Pine St
Lodi, CA 95240-2048
Fax (209) 435-0894
Mailing address
507 Yokuts Dr
Lodi, CA 95240-0690
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | 47392 (CA) |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
4 other providers at this address
Other mental health clinic/center (including community mental health center) providers in Lodi
About NPI 1821117284
Matthew Fava's National Provider Identifier is 1821117284, issued on Mar 28, 2007. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Lodi, CA. The record was last updated on Apr 5, 2012.