Individual
AIA ONGPAUCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20946 DEVONSHIRE ST STE 100, CHATSWORTH, CA 91311-8270
(818) 626-8053
Mailing address
20946 DEVONSHIRE ST STE 100, CHATSWORTH, CA 91311-8270
(818) 626-8053
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1506470523
CA
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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