Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003455247 |
---|---|
Provider Name | Mrs. Yeni Patricia Guevara |
First Address | Pico Rivera, CA 90660-3839 |
Second Address | Pico Rivera, CA 90660-3839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2020 |
Last Update Date | 06/01/2020 |