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1144097916
DIANA BORTOLUS
SAN MATEO, CA
NPI
1144097916
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 13485)
Enumeration Date
2023-12-11
Last Update Date
2023-12-11
Business Address
DIANA BORTOLUS SUDRC #13485
2015 PIONEER CT
SAN MATEO, CA 94403-1781
Phone number: 650-348-6603
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Mailing Address
DIANA BORTOLUS SUDRC #13485
2015 PIONEER CT STE B
SAN MATEO, CA 94403-1736
Phone number: 650-348-6603
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