Individual
MR. CARLOS MORENO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14558 SYLVAN ST, VAN NUYS, CA 91411-2324
(818) 787-4151
Mailing address
13935 MULBERRY DR, WHITTIER, CA 90605-3043
(562) 556-1279
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/07/2008
Last updated
01/07/2008
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