Individual
MR. JOHN DAVID BLACK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHRT
Contact information
Practice address
2249 N.M YALE STREET, SANTA ANA, CA 91045
(323) 877-7303
Mailing address
634B EUCLID AVE, DUARTE, CA 91010-3110
(323) 877-7303
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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