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General NPI Number Information
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NPI Number | 1932924339
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Entity Type | Individual
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Provider Name | MR. STEVEN JOHN CARNER
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Gender | Male
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1250 MORENA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92110-3815
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Country | US
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Telephone | 619-692-8750
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Fax |
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Provider Business Mailing Address
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Address Line | 18505 WISECARVER TRUCK TRL
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City | JAMUL
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State | CA
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Zip | 91935-3630
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Country | US
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Telephone | 760-216-0450
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-HQBZYP
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-HQZYP
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License Number State | CA
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