Individual
EVELYN ANGELICA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8142 SUNLAND BLVD, SUN VALLEY, CA 91352
(818) 306-4254
(818) 582-8836
Mailing address
10762 KESWICK ST, SUN VALLEY, CA 91352-4606
(818) 823-4090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R4718
CA
374700000X
Technician
Primary
—
—
Other
Enumeration date
07/05/2017
Last updated
07/21/2022
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