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1811137375
DOMASIO YGNASIO LOPEZ
SACRAMENTO, CA
NPI
1811137375
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 2428)
Enumeration Date
2009-02-24
Last Update Date
2009-02-24
Business Address
Mr. DOMASIO YGNASIO LOPEZ
1820 J ST
SACRAMENTO, CA 95811-3010
Phone number: 916-313-8417
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Mailing Address
Mr. DOMASIO YGNASIO LOPEZ
8642 NEW ISLAND WAY
SACRAMENTO, CA 95828-7548
Phone number: 916-876-5432
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