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Genevieve Maya Fragoso
Professional Counselor in San Dimas, California
NPI 1780319079

Genevieve Maya Fragoso is a Professional Counselor based in San Dimas, CA and is specialized in Professional. Genevieve Maya Fragoso practices in San Dimas, CA. The NPI Number for Genevieve Maya Fragoso is 1780319079 and holds a License No. 15247 (California).

The current practice location address for Genevieve Maya Fragoso is 180 Via Verde Ste 200, San Dimas, CA and can be reached out via phone at 909-599-1227.

Location: 180 Via Verde Ste 200, San Dimas, CA, 91773-3993
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780319079
Provider Name
Genevieve Maya Fragoso
Credential
Provider Entity Type
Individual
Gender
Female
Address
180 Via Verde Ste 200, San Dimas, CA, 91773-3993
Phone Number
909-599-1227
Fax Number
Provider Enumeration Date
07/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
180 Via Verde Ste 200
City
San Dimas
State
California
Zip
91773-3993
Phone Number
909-599-1227
Fax Number
person
Provider Business Mailing Address Details
Address
180 Via Verde Ste 200
City
San Dimas
State
California
Zip
91773-3993
Phone Number
909-599-1227
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
15247 (California)
Definition
Definition to come...
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