Individual
ANDRE FRANK CENICEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
603 D ST, SAN RAFAEL, CA 94901-3719
(415) 454-9444
Mailing address
622 TAMALPAIS DR, CORTE MADERA, CA 94925-1633
(415) 720-9156
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23360-I
CA
Other
Enumeration date
12/18/2023
Last updated
12/30/2024
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