| Wayne Fondren, | |
|
18612 Santa Ana Ave, Bloomington, CA 92316-2639 | |
| (909) 421-7120 | |
| (909) 421-7128 |
| Full Name | Wayne Fondren |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 18612 Santa Ana Ave, Bloomington, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164985677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Fondren, 18612 Santa Ana Ave, Bloomington, CA 92316-2639 Ph: (909) 421-7120 | Wayne Fondren, 18612 Santa Ana Ave, Bloomington, CA 92316-2639 Ph: (909) 421-7120 |
Georgina Lisa Sanchez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 | |
Keiana Dobson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 Fax: 909-421-7128 | |
Nicholas Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 Fax: 909-421-7128 | |
Tammy Ahumada, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 Fax: 909-421-7128 | |
Kennedy Odero, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 Fax: 909-421-7128 | |
Leah Boyd, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 Fax: 909-421-7128 | |
Tammy Reynolds, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18612 Santa Ana Ave, Bloomington, CA 92316 Phone: 909-421-7120 |