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1609641794
JONATHAN IDDAMALGODA
WOODLAND HILLS, CA
NPI
1609641794
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 96000115)
Enumeration Date
2023-11-17
Last Update Date
2023-11-17
Business Address
JONATHAN IDDAMALGODA
6022 VARIEL AVE
WOODLAND HILLS, CA 91367-3719
Phone number: 818-996-1051
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Mailing Address
JONATHAN IDDAMALGODA
6022 VARIEL AVE
WOODLAND HILLS, CA 91367-3719
Phone number: 818-996-1051
Copy
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