Most Relevant Information
Provider Data
| NPI Number: | 1003524711 |
| Provider Name: | ROBERT VAZQUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/10/2022 |
| Last Updated: | 11/10/2022 |
Provider Practice Location
762 CYPRESS ST
SAN DIMAS
CA
917733505
Practice Location Phone/Fax
| Phone: | 9095991227 |
| Fax: |
Provider Mailing Location
762 CYPRESS ST
SAN DIMAS
CA
917733505
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |