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General NPI Number Information
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NPI Number | 1093122608
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Entity Type | Individual
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Provider Name | JOHN ROBERT-CLYDE HELMER PSYD, LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 5360 JACKSON DR STE 220-C
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City | LA MESA
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State | CA
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Zip | 91942
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Country | US
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Telephone | 619-438-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 5360 JACKSON DR STE 220-C
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City | LA MESA
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State | CA
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Zip | 91942-6002
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Country | US
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Telephone | 619-439-8479
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW61313
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY28837
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License Number State | CA
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