Healthcare Provider Details

I. General information

NPI: 1932845302
Provider Name (Legal Business Name): MR. JOHN STEVEN CARLIN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3499 10TH ST
RIVERSIDE CA
92501-3617
US

IV. Provider business mailing address

301 VICTORIA ST
COSTA MESA CA
92627-1995
US

V. Phone/Fax

Practice location:
  • Phone: 951-715-5050
  • Fax:
Mailing address:
  • Phone: 949-574-3367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number139807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: