Individual
BOJ NUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1322 N AVALON BLVD, WILMINGTON, CA 90744-2639
(310) 513-1300
Mailing address
15118 COLONY CT, PARAMOUNT, CA 90723-3591
(562) 235-5075
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/20/2008
Last updated
06/20/2008
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