Individual provider · Type 1 NPI

Boone Martin Tucker

Addiction (Substance Use Disorder) Counselor · San Luis Obispo, CA

NPI number 1902521966 Active

Practice location

2180 Johnson Ave
San Luis Obispo, CA 93401-4558

Call (805) 473-7081 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XRT1437960426 (CA)

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

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About NPI 1902521966

Boone Martin Tucker's National Provider Identifier is 1902521966, issued on Oct 11, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Luis Obispo, CA. The record was last updated on Apr 10, 2026.