Individual provider · Type 1 NPI
John Mattthew Ilonummi, RADT
Addiction (Substance Use Disorder) Counselor · Stockton, CA
NPI number
1417593864
Active
Practice location
1222 Monaco Ct Ste 28
Stockton, CA 95207-6742
Mailing address
102 W Bianchi Rd
Stockton, CA 95207-7132
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 390017AN (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1417593864
John Mattthew Ilonummi, RADT's National Provider Identifier is 1417593864, issued on Nov 20, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Stockton, CA. The record was last updated on Nov 20, 2019.