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1982984985
GABRIEL KOGAN
CHULA VISTA, CA
NPI
1982984985
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA RI-K1108111257)
Enumeration Date
2011-08-22
Last Update Date
2011-08-22
Business Address
-- GABRIEL KOGAN MA, RAS
1161 3RD AVE
CHULA VISTA, CA 91911-3136
Phone number: 619-498-5072
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Mailing Address
-- GABRIEL KOGAN MA, RAS
11905 BLAKE RD
WILTON, CA 95693-8537
Phone number: 916-346-2105
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