Individual
ALDAR FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
491 FORD ST, UKIAH, CA 95482-4017
(707) 467-2010
Mailing address
PO BOX 2077, UKIAH, CA 95482-2077
(707) 467-2010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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