Healthcare Provider Details

I. General information

NPI: 1588013031
Provider Name (Legal Business Name): AUSTIN HUNTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 CORDELL CT STE 101
EL CAJON CA
92020-0915
US

IV. Provider business mailing address

1202 MORENA BLVD SUITE 203
SAN DIEGO CA
92110-3841
US

V. Phone/Fax

Practice location:
  • Phone: 619-448-9700
  • Fax: 619-448-9711
Mailing address:
  • Phone: 619-398-3261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: