Organization
ANNJUDEL C ENRIQUEZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA RABER (SUPERVISOR)
(951) 358-4705
Entity
Organization
Contact information
Practice address
769 W BLAINE ST STE B, RIVERSIDE, CA 92507-3970
(951) 358-4705
Mailing address
769 W BLAINE ST STE B, RIVERSIDE, CA 92507-3970
(951) 358-4705
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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