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General NPI Number Information
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NPI Number | 1073993846
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Entity Type | Organization
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Legal Business Name | W.WOOTON,INC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 333 S JUNIPER ST SUITE 114
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City | ESCONDIDO
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State | CA
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Zip | 92025-4924
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Country | US
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Telephone | 858-610-0438
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Fax |
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Provider Business Mailing Address
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Address Line | 333 S JUNIPER ST SUITE 114
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City | ESCONDIDO
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State | CA
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Zip | 92025-4924
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Country | US
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Telephone | 858-610-0438
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | WILL WOOTON
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Credential | CADC
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Telephone | 858-610-0438
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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 | A017630315
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License Number State | CA
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