KIMBERLY LAVONNE SELF

SANTA ANA, CA
NPI1487123873
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  C059050818)
Enumeration Date2018-11-15
Last Update Date2018-11-15
Business Address
KIMBERLY LAVONNE SELF CADC-1
1207 E FRUIT ST
SANTA ANA, CA 92701-4206
Phone number: 714-953-9373
Mailing Address
KIMBERLY LAVONNE SELF CADC-1
441 S VICKI LN
ANAHEIM, CA 92804-2075
Phone number: 714-450-0352
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