Individual
CHARLES PORTALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11776 MARIPOSA RD, HESPERIA, CA 92345-1622
(760) 956-2462
Mailing address
11776 MARIPOSA RD, HESPERIA, CA 92345-1622
(760) 956-2462
(760) 956-2462
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1614080525
CA
Other
Enumeration date
08/06/2025
Last updated
08/08/2025
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