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1922707751
MARK MATA
SANTA ANA, CA
NPI
1922707751
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1487001122)
Enumeration Date
2023-03-01
Last Update Date
2023-03-01
Business Address
MARK MATA
1225 W 6TH ST
SANTA ANA, CA 92703-2101
Phone number: 714-972-1402
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Mailing Address
MARK MATA
1225 W 6TH ST
SANTA ANA, CA 92703-2101
Phone number: 714-972-1402
Copy
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