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General NPI Number Information
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NPI Number | 1447404926
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Entity Type | Individual
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Provider Name | EDGARDO TOLENTINO
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Gender | Male
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 5674 STONERIDGE DR SUITE 108
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City | PLEASANTON
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State | CA
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Zip | 94588-8500
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Country | US
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Telephone | 925-520-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 5674 STONERIDGE DR
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City | PLEASANTON
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State | CA
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Zip | 94588-8500
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Country | US
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Telephone | 925-520-0005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A37186
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License Number State | CA
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