Individual
MR. CHARLES E FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCAPP RII05130515
Contact information
Practice address
2731 NUGGET AVE, LAKE ISABELLA, CA 93240-9456
(760) 379-3412
Mailing address
29325 KIMBERLINA RD, WASCO, CA 93280
(661) 758-4029
(661) 758-0891
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CCAPP RII05130515
CA
Other
Enumeration date
12/30/2014
Last updated
07/30/2015
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