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1982147401
JACOB DAVIS
LOS ANGELES, CA
NPI
1982147401
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1237171116)
Enumeration Date
2016-12-01
Last Update Date
2016-12-01
Business Address
-- JACOB DAVIS
900 AVILA ST
LOS ANGELES, CA 90012-4287
Phone number: 213-229-0985
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Mailing Address
-- JACOB DAVIS
900 AVILA ST
LOS ANGELES, CA 90012-4287
Phone number: 213-229-0985
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