Individual provider · Type 1 NPI

Wayne Fondren

Addiction (Substance Use Disorder) Counselor · Bloomington, CA

NPI number 1164985677 Active

Practice location

18612 Santa Ana Ave
Bloomington, CA 92316-2639

Call (909) 421-7120 Map

Fax (909) 421-7128

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1164985677

Wayne Fondren's National Provider Identifier is 1164985677, issued on Apr 11, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Bloomington, CA. The record was last updated on Apr 11, 2019.