Individual provider · Type 1 NPI

Domingo Reveron

Addiction (Substance Use Disorder) Counselor · Los Angeles, CA

NPI number 1205055993 Active

Practice location

5220 W Washington Blvd, Suite 101
Los Angeles, CA 90016-1331

Call (323) 933-9186 Map

Mailing address

1737 Whitley Ave, Apt. 510
Hollywood, CA 90028-4862

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 1205055993

Domingo Reveron's National Provider Identifier is 1205055993, issued on Apr 24, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.