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Clarence Anthony Johnson III
Addiction (Substance Use Disorder) Counselor in San Diego, California
NPI 1700599867

Clarence Anthony Johnson III is an Addiction (Substance Use Disorder) Counselor based in San Diego, CA and is specialized in Addiction (Substance Use Disorder). Clarence Anthony Johnson III practices in San Diego, CA. The NPI Number for Clarence Anthony Johnson III is 1700599867 and holds a License No. (California).

The current practice location address for Clarence Anthony Johnson III is 6145 Imperial Ave, San Diego, CA and can be reached out via phone at 619-234-8888.

Location: 6145 Imperial Ave, San Diego, CA, 92114-4213
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700599867
Provider Name
Clarence Anthony Johnson III
Credential
Provider Entity Type
Individual
Gender
Male
Address
6145 Imperial Ave, San Diego, CA, 92114-4213
Phone Number
619-234-8888
Fax Number
Provider Enumeration Date
01/03/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
33-0539640 05 CA
institution
Provider Business Practice Location Address Details
Address
6145 Imperial Ave
City
San Diego
State
California
Zip
92114-4213
Phone Number
619-234-8888
Fax Number
person
Provider Business Mailing Address Details
Address
6145 Imperial Ave
City
San Diego
State
California
Zip
92114-4213
Phone Number
619-234-8888
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.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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