FUMIKO IRENE FUKUMOTO GONZALES

LOS ANGELES, CA
NPI1780225532
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-10-02
Last Update Date2019-10-02
Business Address
FUMIKO IRENE FUKUMOTO GONZALES RADT
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
Mailing Address
FUMIKO IRENE FUKUMOTO GONZALES RADT
1300 SARATOGA AVE UNIT 609
VENTURA, CA 93003-6406
Phone number: 424-404-2437