Individual
WILLIAM DOMINIC DE LA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDRC
Contact information
Practice address
3230 WARING CT STE A, OCEANSIDE, CA 92056-4509
(760) 305-7528
(760) 509-4410
Mailing address
3230 WARING CT STE A, OCEANSIDE, CA 92056-4509
(760) 305-7528
(760) 509-4410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17438
CA
175T00000X
Peer Specialist
Primary
MPSS-YVNQJW
CA
Other
Enumeration date
03/04/2024
Last updated
02/13/2025
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