MICHAEL POTENCIANO

VISTA, CA
NPI1851922702
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2020-01-30
Last Update Date2020-01-30
Business Address
MICHAEL POTENCIANO
1211 W VISTA WAY BLDG C
VISTA, CA 92083-6227
Phone number: 760-721-2781
Mailing Address
MICHAEL POTENCIANO
1400 N JOHNSON AVE STE 101
EL CAJON, CA 92020-1651
Phone number: