Individual provider · Type 1 NPI

Chasmal Tyesha Broderick

Counselor · San Diego, CA

NPI number 1134744634 Active

Practice location

8755 Aero Dr Ste 230
San Diego, CA 92123-1750

Call (858) 256-2180 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1134744634

Chasmal Tyesha Broderick's National Provider Identifier is 1134744634, issued on Jun 10, 2020. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in San Diego, CA. The record was last updated on Jun 10, 2020.