Individual
DESHONDRA L FORTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6160 MISSION GORGE RD STE 108, SAN DIEGO, CA 92120-3425
(619) 481-5200
Mailing address
6160 MISSION GORGE RD STE 108, SAN DIEGO, CA 92120-3425
(619) 481-5200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/15/2017
Last updated
04/24/2019
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