Individual
ETHAN MICHAEL TREVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10927 DOWNEY AVE, DOWNEY, CA 90241-3739
(562) 869-9770
Mailing address
10927 DOWNEY AVE STE C, DOWNEY, CA 90241-3739
(562) 450-3304
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/26/2011
Last updated
02/09/2021
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