Healthcare Provider Details

I. General information

NPI: 1316433949
Provider Name (Legal Business Name): PAUL NAVARETTE MARIN CADC-2
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40925 COUNTY CENTER DR
TEMECULA CA
92591-6054
US

IV. Provider business mailing address

340 RANCHEROS DR STE 166
SAN MARCOS CA
92069-2980
US

V. Phone/Fax

Practice location:
  • Phone: 206-250-1574
  • Fax:
Mailing address:
  • Phone: 760-744-3672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA054951023
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberA054951023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: