Individual
GENEVIEVE GRADILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4440 UNIVERSITY AVE, RIVERSIDE, CA 92501-3199
(951) 683-6596
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 683-9596
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
VN184950
CA
164X00000X
Licensed Vocational Nurse
Primary
184950
CA
Other
Enumeration date
05/04/2021
Last updated
11/14/2024
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