Individual
CHARLIE JOANNE LADISLAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1207 E FRUIT ST, SANTA ANA, CA 92701-4296
(714) 953-9373
Mailing address
2030 E WILSHIRE AVE APT A, FULLERTON, CA 92831-4149
(323) 359-4242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
278921
CA
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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