Individual
CHARLES FARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1652 E DEL MAR BLVD, PASADENA, CA 91106-2706
(626) 792-5508
Mailing address
1652 E DEL MAR BLVD, PASADENA, CA 91106-2706
(626) 792-5508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
F0910011501
CA
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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