GAVIN ULRIC ANDERSON

LOS ANGELES, CA
NPI1245046291
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1568440724)
Enumeration Date2024-12-04
Last Update Date2024-12-04
Business Address
GAVIN ULRIC ANDERSON
2521 LONG BEACH AVE
LOS ANGELES, CA 90058-1324
Phone number: 760-905-8063
Mailing Address
GAVIN ULRIC ANDERSON
786 MIRAFLORES
SAN PEDRO, CA 90731-1460
Phone number: 760-905-8063