Individual provider · NPI-1

Mario Angel Acosta

Counselor · Lemon Grove, CA

NPI number1396307229
StatusActive
Last updated in NPPESJul 1, 2019

Details

NPI
1396307229
Entity type
Individual (NPI-1)
Name
Mario Angel Acosta
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 1, 2019
Last updated
Jul 1, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101Y00000X Counselor–CAYes

Practice location

2045 Skyline Dr
Lemon Grove, CA 91945-4221

Phone 619-464-2273

Mailing address

1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651

Phone 207-956-1563

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