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Individual

AGUSTIN VIEYRA ORNELAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1055 W HENDERSON AVE STE 2, PORTERVILLE, CA 93257-1490
(559) 788-1200
Mailing address
1055 W HENDERSON AVE STE 2, PORTERVILLE, CA 93257-1490
(559) 801-9521

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
112881
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112881
BBS
CA
Enumeration date
11/22/2011
Last updated
05/01/2024
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