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1295164101
JAIME CAMPOS
SANTA CRUZ, CA
NPI
1295164101
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA RI-C1306141110)
Enumeration Date
2013-11-01
Last Update Date
2013-11-19
Business Address
JAIME CAMPOS
200 7TH AVE
SANTA CRUZ, CA 95062-4668
Phone number: 831-462-1060
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Mailing Address
JAIME CAMPOS
200 7TH AVE
SANTA CRUZ, CA 95062-4668
Phone number: 831-462-1060
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