Individual
CHARIS MANDUJANO VILLAGOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2403 PROFESSIONAL DR STE 101, SANTA ROSA, CA 95403-3007
(707) 544-3295
Mailing address
2403 PROFESSIONAL DR, SANTA ROSA, CA 95403-3007
(707) 544-3295
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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