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General NPI Number Information
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NPI Number | 1881458008
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Entity Type | Individual
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Provider Name | MERRY WHITTINGTON SUDRC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 1341 N ESCONDIDO BLVD
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City | ESCONDIDO
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State | CA
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Zip | 92026-2507
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Country | US
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Telephone | 760-747-1015
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Fax |
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Provider Business Mailing Address
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Address Line | 6878 NAVAJO RD UNIT 13
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City | SAN DIEGO
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State | CA
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Zip | 92119-1555
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Country | US
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Telephone | 619-840-3906
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17322
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License Number State | CA
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