Individual
MS. BERTHA ALICIA AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RASI
Contact information
Practice address
5244 WOOD AVE, # C, SOUTH GATE, CA 90280-5365
(323) 245-2035
Mailing address
5244 WOOD AVE, C, SOUTH GATE, CA 90280-5365
(323) 245-2035
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-A1201191404
CA
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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