Individual
CESCILY DIANE CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11133 WASHINGTON BLVD, CULVER CITY, CA 90232-3918
(310) 895-2360
Mailing address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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