Individual provider · NPI-1

Edname Estrada Abad Jr.

Counselor, Mental Health · Lemon Grove, CA

NPI number1356647812
StatusActive
Last updated in NPPESFeb 1, 2011

Details

NPI
1356647812
Entity type
Individual (NPI-1)
Name
Mr. Edname Estrada Abad Jr.
Sex
Male
Sole proprietor
No
Enumeration date
Feb 1, 2011
Last updated
Feb 1, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes

Practice location

3434 Grove St
Lemon Grove, CA 91945-1812

Phone 619-259-8888

Mailing address

3434 Grove St
Lemon Grove, CA 91945-1812

Phone 619-259-8888

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