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1730609132
SANTIAGO JESUS REYNOSO
SYLMAR, CA
NPI
1730609132
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-06-27
Last Update Date
2022-07-21
Business Address
SANTIAGO JESUS REYNOSO
13496 GLADSTONE AVE
SYLMAR, CA 91342-2277
Phone number: 818-312-6068
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Mailing Address
SANTIAGO JESUS REYNOSO
13496 GLADSTONE AVE
SYLMAR, CA 91342-2277
Phone number: 818-312-6068
Copy
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