Individual provider · Type 1 NPI

Jacob Christian Wickham, CMPSS

Addiction (Substance Use Disorder) Counselor · Campo, CA

NPI number 1376306183 Active

Practice location

1777 Buckman Springs Rd
Campo, CA 91906-2022

Call (619) 478-5696 Map

Fax (619) 478-2404

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XR1536221123 (CA)
Peer Specialist 175T00000XMPSS-ZWRITX (CA)

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

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About NPI 1376306183

Jacob Christian Wickham, CMPSS's National Provider Identifier is 1376306183, issued on Feb 5, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Campo, CA. The record was last updated on Dec 17, 2025.