Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | IMF85996 | CA |
NPI | 1003276700 |
---|---|
Provider Name | Claudio Nunez |
First Address | Costa Mesa, CA 92627-2529 |
Second Address | Costa Mesa, CA 92627-2529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2016 |
Last Update Date | 24/02/2016 |