Individual
BEN MANCILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 7TH AVE STE 150, SANTA CRUZ, CA 95062-4669
(831) 462-1060
Mailing address
200 7TH AVE STE 150, SANTA CRUZ, CA 95062-4669
(831) 462-1060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1495420123
CA
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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