Individual
JACQUELINE FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3250 WILSHIRE BLVD, LOS ANGELES, CA 90010-1577
(323) 361-2350
Mailing address
2410 ALICE RODRIGUEZ CIR, DUARTE, CA 91010-3902
(626) 320-0178
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/28/2024
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