Individual
CARLOS ALBERTO PONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 N 8TH ST, EL CENTRO, CA 92243-2302
(442) 265-1525
Mailing address
202 N 8TH ST, EL CENTRO, CA 92243-2302
(442) 265-1525
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APCC5507
CA
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
07/16/2018
Last updated
03/13/2019
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