Individual
ANTONIO BANUELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
10515 BALBOA BLVD STE 150, GRANADA HILLS, CA 91344-6355
(818) 488-3880
(213) 652-1815
Mailing address
4515 N ELLEN DR, COVINA, CA 91722-2331
(626) 534-7009
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
11/18/2025
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