EDGAR ONTIVEROS

CLEARLAKE, CA
NPI1891517124
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: CA  MPSS-WEYLRB)
Enumeration Date2024-10-28
Last Update Date2024-10-30
Business Address
EDGAR ONTIVEROS
14096 LAKESHORE DR
CLEARLAKE, CA 95422-8160
Phone number: 707-994-4261
Mailing Address
EDGAR ONTIVEROS
PO BOX 1024
LUCERNE, CA 95458-1024
Phone number: 707-274-9101