MATTHEW FAVA

NPI # 

Practice Address:

404 W Pine St

Lodi, CA, 95240-2048

Practice Phone:

209-769-9554

Practice Fax:

209-435-0894

License Number:

47392

License State:

CA

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Mental Health (Including Community Mental Health Center)

Taxonomy Code:

261QM0801X

Updated by NPPES on 4/5/2012. You can view the original data set for NPI # 1821117284 on the official NPPES website. If the information about this NPI provider/company is outdated you can request updates through the NPPES website. See our FAQ page for more information.

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MATTHEW FAVA's

CMS CPT® coding data

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MATTHEW FAVA's

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