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CHRISTINE SHIRLEY POTAPOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RADT

Contact information

Practice address
20331 FLANAGAN ROAD, TRABUCO CANYON, CA 92679
(818) 582-8832
(818) 582-8836
Mailing address
24522 BENDRICON LN APT D, LAKE FOREST, CA 92630-8603
(949) 898-0080

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1562940624
CA

Other

Enumeration date
06/25/2024
Last updated
06/25/2024
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