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1841054806
ELLAINE PERALTA
SAN PEDRO, CA
NPI
1841054806
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1545970124)
Enumeration Date
2024-02-09
Last Update Date
2024-02-09
Business Address
ELLAINE PERALTA
505 S PACIFIC AVE
SAN PEDRO, CA 90731-2656
Phone number: 310-519-8723
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Mailing Address
ELLAINE PERALTA
13302 SISKIYOU ST
WESTMINSTER, CA 92683-2114
Phone number: 424-334-9357
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