Individual
BOBBY GOLOB AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT-1
Contact information
Practice address
1225 W 6TH ST, SANTA ANA, CA 92703-2101
(714) 972-1402
Mailing address
1225 W 6TH ST, SANTA ANA, CA 92703-2101
(714) 972-1402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1267640917
CA
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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