Souza, Mario Antonio

Souza, Mario Antonio is an sole proprietor health care provider with primary practice located at 3102 E Highland Ave , Patton CA 92369-7813. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Forensic is his primary health care specialty. Souza, Mario Antonio can be contacted via phone (909) 425-7000.

Contact Information

Primary practice address
3102 E Highland Ave Patton CA 92369-7813
Phone: (909) 425-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Forensic 103TF0200X D6738240 California

Profile Details

NPI number 1386083012
LBN Legal business name Souza, Mario Antonio
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2013
Last updated Mar 18th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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