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Individual

MR. HUEY LION FAIRWEATHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2035 EAST BALL ROAD, ANAHEIM, CA 92806-4434
(714) 480-6476
Mailing address
1300 S GRAND AVE STE B, SANTA ANA, CA 92705-4434
(714) 480-6476

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
128646
CA

Other

Enumeration date
08/29/2018
Last updated
07/22/2025
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