Individual
CHARLES YOVANNE MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
225 N MARIPOSA AVE, LOS ANGELES, CA 90004-4509
(213) 736-5441
Mailing address
5233 E BEVERLY BLVD, EAST LOS ANGELES, CA 90022-2020
(323) 499-3650
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19744
CA
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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