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1164157798
JASON CHARLES BONDERER
PLACERVILLE, CA
NPI
1164157798
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1474650722)
Enumeration Date
2022-07-18
Last Update Date
2022-07-18
Business Address
JASON CHARLES BONDERER RADT-1
2844 COLOMA ST
PLACERVILLE, CA 95667-4406
Phone number: 530-626-6290
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Mailing Address
JASON CHARLES BONDERER RADT-1
2844 COLOMA ST
PLACERVILLE, CA 95667-4406
Phone number: 530-626-6290
Copy
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