Individual provider · Type 1 NPI

Timothy John Shocklee, 2113397 I

Addiction (Substance Use Disorder) Counselor · Riverside, CA

NPI number 1891330536 Active

Practice location

2085 Rustin Ave
Riverside, CA 92507-2498

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed
Case Manager/Care Coordinator 171M00000XNone listed

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About NPI 1891330536

Timothy John Shocklee, 2113397 I's National Provider Identifier is 1891330536, issued on Nov 15, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Riverside, CA. The record was last updated on May 1, 2024.