Individual
ANDREA CLARK CARMONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
20331 FLANAGAN ROAD, TRABUCO CANYON, CA 92679
(818) 582-8832
(818) 582-8836
Mailing address
142 WILD HORSE LOOP, RANCHO SANTA MARGARITA, CA 92688-1805
(801) 310-9227
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CI29070220
CA
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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