Individual
CLARA PONDECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26120 N POSEIDON RD, FLORENCE, AZ 85132-5537
(703) 200-8360
Mailing address
929 N VAL VISTA DR STE 109, GILBERT, AZ 85234-3701
(480) 331-3231
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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