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1437283785
JEFFERY A VANDYKE
LAKE ELSINORE, CA
NPI
1437283785
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 01-035088)
Enumeration Date
2007-03-16
Last Update Date
2007-07-08
Business Address
-- JEFFERY A VANDYKE c.a.s.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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Mailing Address
-- JEFFERY A VANDYKE c.a.s.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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