Individual
BRYAN A HENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
563 LYTLE CREEK RD, P O BOX 158, LYTLE CREEK, CA 92358
(909) 704-5789
Mailing address
563 LYTLE CREEK RD POX158, LYTLE CREEK, CA 92358
(909) 704-5789
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
CA
Other
Enumeration date
12/26/2025
Last updated
12/26/2025
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