MEDICARE: MS. VELMA VERNAY JUSTICE-ROYSTER LAADC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCI12590618	CA
2	106H00000X	Marriage & Family Therapist	LMFT107386	CA
3	106H00000X	Marriage & Family Therapist
4	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1093923922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VELMA VERNAY JUSTICE-ROYSTER LAADC, LMFT

Provider Business Mailing Address
First Line	:	2949 DEGEN DR
Second Line	:
City	:	BONITA
State	:	CA
Zip	:	91902-2155
Country	:	US
Telephone Number	:	619-788-7327
Fax Number	:	619-543-7615

Provider Business Practice Location Address
First Line	:	200 W ARBOR DR # 8681
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1911
Country	:	US
Telephone Number	:	619-543-4621
Fax Number	:	619-543-3964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	02/27/2024

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