Individual
ANGELICA BANUELOS VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35658 FIR AVE, YUCAIPA, CA 92399-9634
(909) 312-8744
Mailing address
35658 FIR AVE, YUCAIPA, CA 92399-9634
(909) 312-8744
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
148954
CA
106H00000X
Marriage & Family Therapist
AMFT112732
CA
Other
Enumeration date
11/04/2019
Last updated
09/16/2024
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