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1013620699
JUAN JOSE BOLANOS
RICHMOND, CA
NPI
1013620699
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1488401122)
Enumeration Date
2022-12-28
Last Update Date
2023-05-11
Business Address
JUAN JOSE BOLANOS
12960 SAN PABLO AVE
RICHMOND, CA 94805-1307
Phone number: 510-215-2280
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Mailing Address
JUAN JOSE BOLANOS
1901 CHURCH LN
SAN PABLO, CA 94806-3707
Phone number: 516-236-1004
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