MARK MATA

SANTA ANA, CA
NPI1922707751
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1487001122)
Enumeration Date2023-03-01
Last Update Date2023-03-01
Business Address
MARK MATA
1225 W 6TH ST
SANTA ANA, CA 92703-2101
Phone number: 714-972-1402
Mailing Address
MARK MATA
1225 W 6TH ST
SANTA ANA, CA 92703-2101
Phone number: 714-972-1402
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