Juan Graciano, LVN

NPI 1477998136 · on the registry since 2013 · sole proprietor

Practice

Address: 3940 Home Ave
San Diego, CA 92105
Phone: (619) 262-8000
Fax: (619) 266-7405
Organisation at this address: Home Avenue Ctc
Duangtavan Sourivong
Crc Home Avenue Clinic
San Diego Treatment Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 19

Registry record

Primary taxonomy: Methadone Clinic
261QM2800X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2013-05-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California