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MS. ILSE AHUMADA AA

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1871156364

Individual Registrant:
MS. ILSE  AHUMADA AA
Gender: F
Sole Proprietor

Location and contact information for practice:
1628 BROADWAY ST STE B  VALLEJO, CA 94590-2405 US
Tel: 707-649-8300  Fax: --

Contact information for business:
425 ARKANSAS ST  VALLEJO, CA 94590-3872 US
Tel: 707-805-6374  Fax: --

Registration Information:
NPI: 1871156364
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
CAR1285781217

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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