Individual
MR. CARLOS DE LA CERDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 BRADEN AVE # 321, MODESTO, CA 95356-0648
(209) 404-2101
Mailing address
2800 BRADEN AVE # 321, MODESTO, CA 95356-0648
(209) 404-2101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A0683425
CA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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