Individual
ANGELINA LINETTE FUENTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUD COUNSELOR
Contact information
Practice address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 521-1805
Mailing address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 521-1805
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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