person
Mr. Cedric Antron Staton, LPCC
Mental Health Counselor in San Diego, California
NPI 1417616236

Cedric Antron Staton is a Mental Health Counselor based in San Diego, CA and is specialized in Mental Health. Cedric Antron Staton practices in San Diego, CA and has the professional credentials of LPCC. The NPI Number for Cedric Antron Staton is 1417616236 and holds a License No. 11040 (California).

The current practice location address for Cedric Antron Staton is 2525 Camino Del Rio S Ste 313, San Diego, CA and can be reached out via phone at 442-322-8143 and via fax at 619-598-0594.

Location: 2525 Camino Del Rio S Ste 313, San Diego, CA, 92108-4736
person
Provider Profile Details
NPI Number
1417616236
Provider Name
Cedric Antron Staton
Credential
LPCC
Provider Entity Type
Individual
Gender
Male
Address
2525 Camino Del Rio S Ste 313, San Diego, CA, 92108-4736
Phone Number
442-322-8143
Fax Number
619-598-0594
Provider Enumeration Date
12/08/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LPCC11040 01 CA CALIFORNIA BOARD OF BEHAVIORAL SCIENCES
institution
Provider Business Practice Location Address Details
Address
2525 Camino Del Rio S Ste 313
City
State
Zip
92108-3784
Phone Number
442-322-8143
Fax Number
619-598-0594
person
Provider Business Mailing Address Details
Address
2525 Camino Del Rio S Ste 313
City
State
Zip
92108-3784
Phone Number
442-322-8143
Fax Number
619-598-0594
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
11040 (California)
Definition
Definition to come...
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