Individual
ADRIAN REVELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW #112718
Contact information
Practice address
505 S PACIFIC AVE STE 101, SAN PEDRO, CA 90731-2656
(310) 774-0875
Mailing address
7554 WELLMAN ST, COMMERCE, CA 90040-3314
(323) 868-1281
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
112718
CA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
03/11/2019
Last updated
07/04/2024
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