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Individual

BRENDA AVILA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL

Contact information

Practice address
1370 S STATE ST STE A, SAN JACINTO, CA 92583-4922
(951) 791-3350
Mailing address
1370 S STATE ST STE A, SAN JACINTO, CA 92583-4922
(951) 761-3350

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
CA
175T00000X
Peer Specialist
Primary

Other

Enumeration date
08/21/2017
Last updated
03/26/2024
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