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1902672603
DOMINIC SAVIO ORTIZ
SAN RAFAEL, CA
NPI
1902672603
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 16296)
Enumeration Date
2023-12-04
Last Update Date
2023-12-04
Business Address
DOMINIC SAVIO ORTIZ SUDRC 16296
13 PETER BEHR DR
SAN RAFAEL, CA 94903-5216
Phone number: 415-473-4161
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Mailing Address
DOMINIC SAVIO ORTIZ SUDRC 16296
13 PETER BEHR DR
SAN RAFAEL, CA 94903-5216
Phone number: 415-473-4161
Copy
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