Individual provider · Type 1 NPI

Robert Carl Ketchum, CATC1

Addiction (Substance Use Disorder) Counselor · San Jacinto, CA

NPI number 1487025136 Active

Practice location

1370 S State St Ste A
San Jacinto, CA 92583-4922

Fax (951) 791-3353

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XK1208311033 (CA)
Case Manager/Care Coordinator 171M00000XC054940518 (CA)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XC054940518 (CA)

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About NPI 1487025136

Robert Carl Ketchum, CATC1's National Provider Identifier is 1487025136, issued on Oct 7, 2015. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Jacinto, CA. The record was last updated on Apr 16, 2024.