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1457680639
JOSEPH EDWARD FUENTES
POMONA, CA
NPI
1457680639
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA CORPHQ-1057-011611P)
Enumeration Date
2009-12-16
Last Update Date
2009-12-16
Business Address
Mr. JOSEPH EDWARD FUENTES
160 E HOLT AVE STE B
POMONA, CA 91767-5407
Phone number: 909-620-2521
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Mailing Address
Mr. JOSEPH EDWARD FUENTES
7045 CHICAGO CT
ALTA LOMA, CA 91701-5392
Phone number: 909-215-2183
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