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1821537366
ELISEO ANTONIO HEREDIA
MODESTO, CA
NPI
1821537366
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-02-16
Last Update Date
2024-12-02
Business Address
ELISEO ANTONIO HEREDIA
1539 MCHENRY AVE
MODESTO, CA 95350-4528
Phone number: 209-758-0825
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Mailing Address
ELISEO ANTONIO HEREDIA
3433 W SHAW AVE STE 108
FRESNO, CA 93711-3229
Phone number: 559-558-4051
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