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Terrell Jason Fortune
Addiction (Substance Use Disorder) Counselor in San Mateo, California
NPI 1720349731

Terrell Jason Fortune is an Addiction (Substance Use Disorder) Counselor based in San Mateo, CA and is specialized in Addiction (Substance Use Disorder). Terrell Jason Fortune practices in San Mateo, CA. The NPI Number for Terrell Jason Fortune is 1720349731 and holds a License No. (California).

The current practice location address for Terrell Jason Fortune is 720 S. B St., San Mateo, CA and can be reached out via phone at 650-579-7157 and via fax at 650-579-5530.

Location: 720 S. B St., San Mateo, CA, 94401
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720349731
Provider Name
Terrell Jason Fortune
Credential
Provider Entity Type
Individual
Gender
Male
Address
720 S. B St., San Mateo, CA, 94401
Phone Number
650-579-7157
Fax Number
650-579-5530
Provider Enumeration Date
06/06/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
720 S. B St.
City
San Mateo
State
California
Zip
94401
Phone Number
650-579-7157
Fax Number
650-579-5530
person
Provider Business Mailing Address Details
Address
720 S. B St.
City
San Mateo
State
California
Zip
94401
Phone Number
650-579-7157
Fax Number
650-579-5530
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...
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