Individual
ALONZO EISON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14715 EAST HWY 20, CLEARLAKE OAKS, CA 95453
(707) 998-1800
(707) 998-0122
Mailing address
PO BOX 316, LUCERNE, CA 95458-0316
(707) 998-1800
(707) 998-0122
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SUDRC18607
CA
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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