IVAN VILLASENOR

PASADENA, CA
NPI1053080564
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2021-09-08
Last Update Date2021-09-08
Business Address
IVAN VILLASENOR
1230 N MARENGO AVE
PASADENA, CA 91103-2217
Phone number: 626-797-1124
Mailing Address
IVAN VILLASENOR
2725 FAIR OAKS AVE
ALTADENA, CA 91001-4753
Phone number: 562-726-8193