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ANDREW JERROD CAMPBELL

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1689214751

Individual Registrant:
 ANDREW JERROD CAMPBELL 
Gender: M
Sole Proprietor

Location and contact information for practice:
345A DELAWARE ST  IMPERIAL BEACH, CA 91932-1420 US
Tel: 619-633-6166  Fax: --

Contact information for business:
345A DELAWARE ST  IMPERIAL BEACH, CA 91932-1420 US
Tel: 619-633-6166  Fax: --

Registration Information:
NPI: 1689214751
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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