Individual
ANDREA HERBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 VALLEY BLVD, POMONA, CA 91768-3325
(909) 865-2336
Mailing address
2180 VALLEY BLVD, POMONA, CA 91768-3325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1462320322
CCAPP
CA
Enumeration date
05/18/2022
Last updated
05/18/2022
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