Individual provider · Type 1 NPI

Jerry Michael MC Mullen

Mental Health Counselor · Santa Cruz, CA

NPI number 1366647620 Active

Practice location

1400 Emeline Ave Bldg K
Santa Cruz, CA 95060-1976

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1366647620

Jerry Michael MC Mullen's National Provider Identifier is 1366647620, issued on Jun 18, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Santa Cruz, CA. The record was last updated on Jul 8, 2007.