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1619701018
DEMETRIUS JERRELL
SAN DIEGO, CA
NPI
1619701018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 19181)
Enumeration Date
2024-08-28
Last Update Date
2024-08-28
Business Address
Mr. DEMETRIUS JERRELL SUDRC
6145 IMPERIAL AVE
SAN DIEGO, CA 92114-4213
Phone number: 619-234-8888
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Mailing Address
Mr. DEMETRIUS JERRELL SUDRC
6145 IMPERIAL AVE
SAN DIEGO, CA 92114-4213
Phone number: 619-234-8888
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