Individual
MR. GUILLERMO BEENE VICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1615 FRENCH ST, SANTA ANA, CA 92701-2475
(714) 824-8140
(714) 824-8141
Mailing address
1015 KENT DR, SAN DIMAS, CA 91773-4611
(909) 962-5014
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN223287
CA
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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