Individual provider · Type 1 NPI

Wanda Denise Street, MD

Mental Health Counselor · San Jacinto, CA

NPI number 1295918985 Active

Practice location

102 W Main St
San Jacinto, CA 92583-4121

Call (951) 929-2744 Map

Mailing address

5203 El Cerrito Dr Apt 237
Riverside, CA 92507-6288

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1295918985

Wanda Denise Street, MD's National Provider Identifier is 1295918985, issued on Dec 17, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Jacinto, CA. The record was last updated on Dec 17, 2007.