Individual
ANDRES DE JESUS MAYORGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
13222 CHAPMAN AVE, GARDEN GROVE, CA 92840-4414
(714) 683-7566
Mailing address
13222 CHAPMAN AVE, GARDEN GROVE, CA 92840-4414
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1562110524
CA
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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