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1245767342
RALPH GONGORA
LA PUENTE, CA
NPI
1245767342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-05-19
Last Update Date
2017-05-19
Business Address
RALPH GONGORA
15229 E. AMAR ROAD
LA PUENTE, CA 91744
Phone number: 626-855-5090
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Mailing Address
RALPH GONGORA
6926 GRETNA AVE
WHITTIER, CA 90606-1905
Phone number: 562-665-6836
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