Individual
MRS. GEORGINA R VITALE-HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
771 W ORANGETHORPE AVE, FULLERTON, CA 92832-2806
(714) 879-2741
Mailing address
771 W ORANGETHORPE AVE, FULLERTON, CA 92832-2806
(714) 879-2741
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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