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1487940755
ROGER ANTONIO PORTILLO
MONTEBELLO, CA
NPI
1487940755
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCSW87707)
Enumeration Date
2011-06-24
Last Update Date
2023-09-22
Business Address
ROGER ANTONIO PORTILLO
405 N 19TH ST
MONTEBELLO, CA 90640-3942
Phone number: 323-788-6298
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Mailing Address
ROGER ANTONIO PORTILLO
11741 TELEGRAPH RD
SANTA FE SPRINGS, CA 90670-3681
Phone number: 562-949-8455
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