Individual provider · Type 1 NPI

Jesse Bullock

Mental Health Counselor · Alpine, CA

NPI number 1457005365 Active

Practice location

2271 Alpine Blvd Ste A
Alpine, CA 91901-1101

Call (619) 289-7322 Map

Mailing address

13191 Kellam Ct Apt 95
San Diego, CA 92130-1279

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1457005365

Jesse Bullock's National Provider Identifier is 1457005365, issued on Feb 9, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Alpine, CA. The record was last updated on Feb 9, 2022.