Individual
DEANA PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12025 FLORENCE AVE, SANTA FE SPRINGS, CA 90670-4466
(562) 522-3775
Mailing address
12025 FLORENCE AVE, SANTA FE SPRINGS, CA 90670-4466
(562) 522-3775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
46489
CA
Other
Enumeration date
11/21/2024
Last updated
11/21/2024
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