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NPI Code Detail

MEDICARE: MR. JASON ANDREW WHITT

MEDICARE: MR. JASON ANDREW WHITT
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) Counselor

General Provider Information

NPI Number : 1457525677
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON ANDREW WHITT
Provider Business Mailing Address
First Line : 125 RIGG ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-4203
Country : US
Telephone Number : 831-423-3890
Fax Number : 831-423-6657
Provider Business Practice Location Address
First Line : 125 RIGG ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-4203
Country : US
Telephone Number : 831-423-3890
Fax Number : 831-423-6657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2008
Last Update Date : 04/18/2008

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Directions to “ MR. JASON ANDREW WHITT ” Practice Location

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