Individual
DESTINY FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 CARMEN LN, SANTA MARIA, CA 93458-7769
(805) 212-7680
Mailing address
609 S THORNBURG ST, SANTA MARIA, CA 93458-5660
(805) 406-0294
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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