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Vircelito A. Domenden I
Addiction (Substance Use Disorder) Counselor in San Mateo, California
NPI 1720633050

Vircelito A. Domenden I is an Addiction (Substance Use Disorder) Counselor based in Union City, CA and is specialized in Addiction (Substance Use Disorder). Vircelito A. Domenden I practices in San Mateo, CA. The NPI Number for Vircelito A. Domenden I is 1720633050 and holds a License No. (California).

The current practice location address for Vircelito A. Domenden I is 900 Laurel Ave, San Mateo, CA and can be reached out via phone at 650-293-9407.

Location: 900 Laurel Ave, San Mateo, CA, 94587-2546
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720633050
Provider Name
Vircelito A. Domenden I
Credential
Provider Entity Type
Individual
Gender
Male
Address
900 Laurel Ave, San Mateo, CA, 94587-2546
Phone Number
650-293-9407
Fax Number
Provider Enumeration Date
08/05/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
900 Laurel Ave
City
San Mateo
State
California
Zip
94401-4211
Phone Number
650-293-9407
Fax Number
person
Provider Business Mailing Address Details
Address
900 Laurel Ave
City
San Mateo
State
California
Zip
94401-4211
Phone Number
650-293-9407
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
(California)
Definition
Definition to come...
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