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1164277869
KHALIL CEDRIC FORTENBERRY
FREMONT, CA
NPI
1164277869
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 132001)
Enumeration Date
2024-04-17
Last Update Date
2024-04-17
Business Address
KHALIL CEDRIC FORTENBERRY AMFT
39159 PASEO PADRE PKWY
FREMONT, CA 94538-1608
Phone number: 510-952-1191
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Mailing Address
KHALIL CEDRIC FORTENBERRY AMFT
1145 61ST AVE
OAKLAND, CA 94621-3913
Phone number: 510-289-7339
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