Individual
BRYAN FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 S HARBOR BLVD STE 100, ANAHEIM, CA 92805-5188
(657) 208-3188
Mailing address
731 S VAN NESS AVE, SANTA ANA, CA 92701-5550
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
7568
CA
Other
Enumeration date
03/04/2024
Last updated
03/05/2024
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