Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CA |
NPI | 1003454026 |
---|---|
Provider Name | Donaciano Nunez |
First Address | Visalia, CA 93292-3309 |
Second Address | Visalia, CA 93292-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2019 |
Last Update Date | 20/12/2019 |