JONATHAN EVANCULLA

LOS ANGELES, CA
NPI1740840214
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  103106)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: CA  103106)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2019-06-17
Last Update Date2021-08-25
Business Address
JONATHAN EVANCULLA
4211 AVALON BLVD
LOS ANGELES, CA 90011-5622
Phone number: 323-233-0425
Mailing Address
JONATHAN EVANCULLA
4211 AVALON BLVD
LOS ANGELES, CA 90011-5622
Phone number: 323-233-0425