Fuentes, Serena Raquel

Fuentes, Serena Raquel is an individual health care provider with primary practice located at 3316 W Beverly Blvd , Montebello CA 90640-1537. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Fuentes, Serena Raquel can be contacted via phone (323) 722-4529.

Contact Information

Primary practice address
3316 W Beverly Blvd Montebello CA 90640-1537
Phone: (323) 722-4529
Fax: (323) 722-4450
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X California

Profile Details

NPI number 1609210863
LBN Legal business name Fuentes, Serena Raquel
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2013
Last updated Apr 18th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609210863 NPPES
California Other 02768010 DRUG MEDI-CAL

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