Individual provider · Type 1 NPI

Johnny Blackwell Jr., A.A.

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

NPI number 1558708016 Active

Practice location

3340 Kemper St, Ste., 103
San Diego, CA 92110-4906

Call (619) 758-1433 Map

Mailing address

4361 Idaho St, #7
San Diego, CA 92104-1252

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1558708016

Johnny Blackwell Jr., A.A.'s National Provider Identifier is 1558708016, issued on May 23, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Diego, CA. The record was last updated on May 23, 2013.