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1184445108
JESSIE HEREDIA
GLENDALE, CA
NPI
1184445108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-10-22
Last Update Date
2024-10-22
Business Address
JESSIE HEREDIA
4544 SAN FERNANDO RD STE 201
GLENDALE, CA 91204-5015
Phone number: 866-989-1195
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Mailing Address
JESSIE HEREDIA
4544 SAN FERNANDO RD STE 201
GLENDALE, CA 91204-5015
Phone number: 866-989-1195
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