Healthcare Provider Details

I. General information

NPI: 1285563981
Provider Name (Legal Business Name): JOSEPH EDWARD GELETKO APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 OCEAN RANCH BLVD STE 120
OCEANSIDE CA
92056-2700
US

IV. Provider business mailing address

3609 OCEAN RANCH BLVD STE 120
OCEANSIDE CA
92056-2700
US

V. Phone/Fax

Practice location:
  • Phone: 760-418-4611
  • Fax:
Mailing address:
  • Phone: 760-553-3029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: