Provider Demographics
NPI:1386150886
Name:APODACA, ABEL JOSEPH JR (MPA, RADT1)
Entity type:Individual
Prefix:MR
First Name:ABEL
Middle Name:JOSEPH
Last Name:APODACA
Suffix:JR
Gender:M
Credentials:MPA, RADT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2220
Mailing Address - Country:US
Mailing Address - Phone:213-342-3114
Mailing Address - Fax:
Practice Address - Street 1:512 EAST 4TH STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013
Practice Address - Country:US
Practice Address - Phone:213-342-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)