Individual
TANYA RIDAURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 W MAIN ST STE 104, EL CENTRO, CA 92243-2900
(760) 353-3538
(760) 353-8441
Mailing address
PO BOX 63, SEELEY, CA 92273-0063
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
14445
CA
Other
Enumeration date
04/01/2021
Last updated
10/27/2023
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