Individual
IRIS FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
299 12TH ST STE B, MARINA, CA 93933-6003
(831) 883-3030
Mailing address
299 12TH ST STE B, MARINA, CA 93933-6003
(831) 883-3032
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/17/2026
Last updated
02/17/2026
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