Individual
JUSTIN LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25402 PACIFICA AVE, MISSION VIEJO, CA 92691-3854
(949) 238-2400
Mailing address
3815 MARCONI AVE, SACRAMENTO, CA 95821-3867
(925) 705-2215
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
10/20/2020
Last updated
08/07/2025
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