Individual
CARLENE MIRAN MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 COLUMBIA AVE # 200, LOS ANGELES, CA 90017-1209
(213) 249-9388
(626) 961-1810
Mailing address
515 COLUMBIA AVE # 200, LOS ANGELES, CA 90017-1209
(213) 249-9388
(626) 961-1810
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2013518
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1224970316
CA
Other
Enumeration date
10/17/2016
Last updated
11/30/2021
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