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Individual

CHAD BEVILACQUA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
40329 STETSON AVE, HEMET, CA 92544-7358
(951) 658-4466
(951) 674-5227
Mailing address
600 3RD ST, LAKE ELSINORE, CA 92530-2748
(951) 674-5354
(951) 674-5227

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAS
CA

Other

Enumeration date
01/08/2008
Last updated
01/08/2008
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