Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003327636 |
---|---|
Provider Name | John Esten |
First Address | El Cajon, CA 92020-1651 |
Second Address | Chula Vista, CA 91911-3139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2017 |
Last Update Date | 26/08/2020 |