Individual
MS. ANA ROSA FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 277-2601
Mailing address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 277-2601
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
04/30/2018
Last updated
07/05/2023
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