Okeke Kevin Bazemore
Peer Specialist in San Diego, CA. Individual provider (NPI-1).
NPI number1982240818
StatusActive
Last updated in NPPESApr 18, 2024
Details
- NPI
- 1982240818
- Entity type
- Individual (NPI-1)
- Name
- Okeke Kevin Bazemore
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 26, 2019
- Certification date
- Apr 18, 2024
- Last updated
- Apr 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
3491 Kurtz St # 150San Diego, CA 92110-4430
Phone 619-276-1176
Mailing address
3491 Kurtz St # 150San Diego, CA 92110-4430
Phone 619-276-1176
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