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1083745061
CARMEN M VITAL
SAN JOSE, CA
NPI
1083745061
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-03-08
Last Update Date
2007-07-08
Business Address
Mrs. CARMEN M VITAL
2425 ENBORG LN
SAN JOSE, CA 95128-2648
Phone number: 408-885-5400
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Mailing Address
Mrs. CARMEN M VITAL
1306 COTTERELL DR
SAN JOSE, CA 95121-2518
Phone number: 408-885-5400
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