Individual provider · NPI-1

Joseph Alexander Allen III

Peer Specialist · Long Beach, CA

NPI number1639917602
StatusActive
Last updated in NPPESJul 29, 2024

Details

NPI
1639917602
Entity type
Individual (NPI-1)
Name
Joseph Alexander Allen III
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 16, 2024
Certification date
Jul 29, 2024
Last updated
Jul 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175T00000X Peer Specialist––Yes

Practice location

221 E Barclay St
Long Beach, CA 90805-2217

Phone 760-590-5630

Mailing address

4907 Linscott Pl Apt 2
Los Angeles, CA 90016-5455

Phone 760-590-5930

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