Individual
BYRON R FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13075 MONTFORD ST, PACOIMA, CA 91331-1818
(818) 554-3727
Mailing address
13075 MONTFORD ST, PACOIMA, CA 91331-1818
(818) 554-3727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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