Individual
BRENDELLE LAZO DIMAANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 W CREST ST, ESCONDIDO, CA 92025-1739
(760) 747-3424
Mailing address
221 W CREST ST STE 210, ESCONDIDO, CA 92025-1739
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
01/21/2022
Last updated
04/18/2025
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