Individual
ILSE CAROLINA ONTIVEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 24TH ST, RICHMOND, CA 94804-1804
(415) 529-0875
Mailing address
200 24TH ST, RICHMOND, CA 94804-1804
(510) 412-9200
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/10/2018
Last updated
05/12/2025
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