Provider Demographics
NPI:1225625213
Name:ABADIA, JONATHAN C (LPT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:C
Last Name:ABADIA
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 GREENWICH DR # A
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-2930
Mailing Address - Country:US
Mailing Address - Phone:209-328-2066
Mailing Address - Fax:
Practice Address - Street 1:1407 GREENWICH DR # A
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-2930
Practice Address - Country:US
Practice Address - Phone:209-328-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health