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1225255268
FABIAN GONZALES
WEST COVINA, CA
NPI
1225255268
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 0)
Enumeration Date
2007-04-19
Last Update Date
2007-07-08
Business Address
Mr. FABIAN GONZALES Addiction Specialist
540 SOUTH EREMLAND DR. SUITE #A
WEST COVINA, CA 91723
Phone number: 626-966-1577
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Mailing Address
Mr. FABIAN GONZALES Addiction Specialist
25 EL NIDO AVENUE APARTMENT #2
PASADENA, CA 91107
Phone number: 626-644-2545
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