person
Jacob Christian Wickham, RADT
Addiction (Substance Use Disorder) Counselor in Campo, California
NPI 1376306183

Jacob Christian Wickham is an Addiction (Substance Use Disorder) Counselor based in Campo, CA and is specialized in Addiction (Substance Use Disorder). Jacob Christian Wickham practices in Campo, CA and has the professional credentials of RADT. The NPI Number for Jacob Christian Wickham is 1376306183 and holds a License No. R1536221123 (California).

The current practice location address for Jacob Christian Wickham is 1777 Buckman Springs Rd, Campo, CA and can be reached out via phone at 619-478-5696 and via fax at 619-478-2404.

Location: 1777 Buckman Springs Rd, Campo, CA, 91906-2022
person
Provider Profile Details
NPI Number
1376306183
Provider Name
Jacob Christian Wickham
Credential
RADT
Provider Entity Type
Individual
Gender
Male
Address
1777 Buckman Springs Rd, Campo, CA, 91906-2022
Phone Number
619-478-5696
Fax Number
619-478-2404
Provider Enumeration Date
02/05/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1777 Buckman Springs Rd
City
State
Zip
91906-2022
Phone Number
619-478-5696
Fax Number
619-478-2404
person
Provider Business Mailing Address Details
Address
1777 Buckman Springs Rd
City
State
Zip
91906-2022
Phone Number
619-478-5696
Fax Number
619-478-2404
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
R1536221123 (California)
Definition
Definition to come...
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