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General NPI Number Information
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NPI Number | 1356409395
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Entity Type | Individual
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Provider Name | JOHNNY LEE GUINN M.S.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 4455 MURPHY CANYON RD
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City | SAN DIEGO
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State | CA
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Zip | 92123-4379
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Country | US
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Telephone | 619-228-1715
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Fax |
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Provider Business Mailing Address
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Address Line | 5807 UNIVERSITY AVE STE A5290
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City | SAN DIEGO
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State | CA
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Zip | 92115-6295
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Country | US
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Telephone | 619-228-1715
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFC 47578
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4101006464
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License Number State | MI
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