Individual
DEJA COLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Mailing address
5100 ALCOY CT, QUARTZ HILL, CA 93536-4374
(661) 488-4882
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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