Healthcare Provider Details

I. General information

NPI: 1487703344
Provider Name (Legal Business Name): MARCUS ALEXANDER JUSTICE CCAPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 9TH ST
SAN FRANCISCO CA
94103-2603
US

IV. Provider business mailing address

170 9TH ST
SAN FRANCISCO CA
94103-2603
US

V. Phone/Fax

Practice location:
  • Phone: 415-777-0333
  • Fax:
Mailing address:
  • Phone: 415-777-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC058550618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: