Healthcare Provider Details

I. General information

NPI: 1154867661
Provider Name (Legal Business Name): HUFFMAN HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18029 CALLE AMBIENTE SUITE 506
SAN DIEGO CA
92127-0001
US

IV. Provider business mailing address

18029 CALLE AMBIENTE SUITE 506
SAN DIEGO CA
92127-0001
US

V. Phone/Fax

Practice location:
  • Phone: 949-544-3611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: JAMES HUFFMAN
Title or Position: CEO
Credential:
Phone: 949-554-3611