NPI 1891517124
Edgar Ontiveros
Practice location
- Address
- 14096 Lakeshore Dr, Clearlake, CA 95422-8160
- Phone
- (707) 994-4261
- Mailing address
- PO Box 1024, Lucerne, CA 95458-1024
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1891517124
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 28 Oct 2024
- Record last updated
- 30 Oct 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.