Individual
IVAN PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1738 S TREMONT ST, OCEANSIDE, CA 92054-5309
(760) 547-1381
(760) 231-5574
Mailing address
1738 S TREMONT ST, OCEANSIDE, CA 92054-5309
(760) 439-2800
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11940
CA
Other
Enumeration date
12/09/2019
Last updated
09/18/2024
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