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1508539669
JEFFREY KENT NISS
VISTA, CA
NPI
1508539669
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA C7801214)
Enumeration Date
2021-07-26
Last Update Date
2021-07-26
Business Address
Mr. JEFFREY KENT NISS CCAPP C7801214
733 S SANTA FE AVE
VISTA, CA 92083-5939
Phone number: 760-945-5290
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Mailing Address
Mr. JEFFREY KENT NISS CCAPP C7801214
2130 S SANTA FE AVE APT 28
VISTA, CA 92084-7853
Phone number: 760-214-0378
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