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NPI Code Detail

MEDICARE: JON KARMAZIN CADC-CAS

MEDICARE: JON KARMAZIN CADC-CAS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor11952-RCA
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1346734969
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON KARMAZIN CADC-CAS
Provider Business Mailing Address
First Line : 3651 S CORDOBA AVE APT 10
Second Line :
City : SPRING VALLEY
State : CA
Zip : 91977-1821
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5855 STREAMVIEW DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92105-3910
Country : US
Telephone Number : 619-287-5460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 06/18/2018

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