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1780978692
BENJAMIN MEDINA
VAN NUYS, CA
NPI
1780978692
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 071425-II)
Enumeration Date
2011-06-08
Last Update Date
2011-06-08
Business Address
-- BENJAMIN MEDINA
5935 VAN NUYS BLVD
VAN NUYS, CA 91401-3624
Phone number: 818-285-1900
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Mailing Address
-- BENJAMIN MEDINA
PO BOX 921015
SYLMAR, CA 91392-1015
Phone number: 818-285-1900
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