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General NPI Number Information
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NPI Number | 1063639102
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Entity Type | Individual
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Provider Name | RYAN BUCHMANN MA, MFT, CADC-II
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 325 W WASHINGTON ST STE 2-204
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City | SAN DIEGO
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State | CA
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Zip | 92103-1946
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Country | US
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Telephone | 760-566-8760
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Fax | 760-820-2461
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Provider Business Mailing Address
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Address Line | 325 W WASHINGTON ST STE 2-204
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City | SAN DIEGO
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State | CA
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Zip | 92103-1946
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Country | US
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Telephone | 760-566-8760
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Fax | 760-820-2461
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A019280715
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 50774
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License Number State | CA
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