CHARLES ELLIS

SAN DIEGO, CA
NPI1841064912
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1527390923)
Enumeration Date2023-11-09
Last Update Date2023-11-09
Business Address
CHARLES ELLIS
835 25TH ST
SAN DIEGO, CA 92102-2738
Phone number: 619-239-9691
Mailing Address
CHARLES ELLIS
835 25TH ST
SAN DIEGO, CA 92102-2738
Phone number: 619-239-9691