Individual provider · Type 1 NPI

Justin Wyatt Ciasullo

Addiction (Substance Use Disorder) Counselor · Upland, CA

NPI number 1346068624 Active

Practice location

239 W 9th St
Upland, CA 91786-5979

Call (909) 981-6121 Map

Mailing address

28561 Kalmia Ave
Moreno Valley, CA 92555-6521

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X19137 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1346068624

Justin Wyatt Ciasullo's National Provider Identifier is 1346068624, issued on Sep 26, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Upland, CA. The record was last updated on Oct 24, 2024.