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Jay El Tillman
Addiction (Substance Use Disorder) Counselor in Clearlake, California
NPI 1154501047

Jay El Tillman is an Addiction (Substance Use Disorder) Counselor based in Clearlake, CA and is specialized in Addiction (Substance Use Disorder). Jay El Tillman practices in Clearlake, CA. The NPI Number for Jay El Tillman is 1154501047 and holds a License No. RS2684 (California).

The current practice location address for Jay El Tillman is 6885 Old Hwy 53, Clearlake, CA and can be reached out via phone at 707-995-3235.

Location: 6885 Old Hwy 53, Clearlake, CA, 95422-8134
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1154501047
Provider Name
Jay El Tillman
Credential
Provider Entity Type
Individual
Gender
Male
Address
6885 Old Hwy 53, Clearlake, CA, 95422-8134
Phone Number
707-995-3235
Fax Number
Provider Enumeration Date
11/07/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6885 Old Hwy 53
City
Clearlake
State
California
Zip
95422
Phone Number
707-995-3235
Fax Number
person
Provider Business Mailing Address Details
Address
6885 Old Hwy 53
City
Clearlake
State
California
Zip
95422
Phone Number
707-995-3235
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
RS2684 (California)
Definition
Definition to come...
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