MEDICARE: TURNING POINT COUNSELING FIRM LLC

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	251S00000X	Community/Behavioral Health Agency		CA
2	261Q00000X	Clinic/Center		CA

General Provider Information

NPI Number	:	1912367897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TURNING POINT COUNSELING FIRM LLC

Provider Business Mailing Address
First Line	:	7287 BLACKTON DR
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-7512
Country	:	US
Telephone Number	:	619-865-1016
Fax Number	:

Provider Business Practice Location Address
First Line	:	5532 EL CAJON BLVD STE 4
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-3642
Country	:	US
Telephone Number	:	619-865-1016
Fax Number	:

Authorized Official
Title or Position	:	MS PSYCHOLOGY
Name	:	JEFFREY ANDREW GORDON
Credential	:
Telephone Number	:	619-865-1016

Provider Enumeration Date	:	03/04/2016
Last Update Date	:	03/04/2016

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