Individual
JOE C VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 ALLERTON ST FL 2, REDWOOD CITY, CA 94063-1519
(650) 599-9955
(650) 599-9273
Mailing address
500 ALLERTON ST FL 2, REDWOOD CITY, CA 94063-1519
(650) 599-9955
(650) 599-9273
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99475591C54141
—
CA
Enumeration date
06/21/2014
Last updated
06/21/2014
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