person
Ken Soryadvongsa
Mental Health Counselor in San Diego, California
NPI 1295469930

Ken Soryadvongsa is a Mental Health Counselor based in San Diego, CA and is specialized in Mental Health. Ken Soryadvongsa practices in San Diego, CA. The NPI Number for Ken Soryadvongsa is 1295469930 and holds a License No. (California).

The current practice location address for Ken Soryadvongsa is 928 Broadway, San Diego, CA and can be reached out via phone at 619-977-3716.

Location: 928 Broadway, San Diego, CA, 92101-5514
person
Provider Profile Details
NPI Number
1295469930
Provider Name
Ken Soryadvongsa
Credential
Provider Entity Type
Individual
Gender
Male
Address
928 Broadway, San Diego, CA, 92101-5514
Phone Number
619-977-3716
Fax Number
Provider Enumeration Date
07/09/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
928 Broadway
City
State
Zip
92101-5514
Phone Number
619-977-3716
Fax Number
person
Provider Business Mailing Address Details
Address
928 Broadway
City
State
Zip
92101-5514
Phone Number
619-977-3716
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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