Individual
BEAU RYAN HERRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32555 DEER HOLLOW WAY, TEMECULA, CA 92592-1283
(951) 294-6450
Mailing address
4739 MANSFIELD ST APT 7, SAN DIEGO, CA 92116-2451
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2023
Last updated
03/04/2024
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