JEFFERY YOUNGBLOOD
NPI 1154199925
Counselor - Addiction (Substance Use Disorder) in San Pedro, CA
Active since December 12, 2023
About Jeffery Youngblood NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEFFERY YOUNGBLOOD (NPI 1154199925) is an individual addiction (substance use disorder) provider in San Pedro, California, licensed in California (R1521360823) and active in the NPI registry since December 2023.
NPPES Registry Identity
NPI1154199925
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJEFFERY YOUNGBLOOD
Location Address505 S PACIFIC AVESan Pedro, CA 90731-2656
Mailing Address636 W 8th St Apt 6San Pedro, CA 90731-3194
Phone(310) 519-8723
Sole ProprietorNo
Enumeration DateDecember 12, 2023
NPPES CertifiedDecember 12, 2023
✔ NPI 1154199925 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · R1521360823
505 S PACIFIC AVE, San Pedro, CA 90731
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Community/Behavioral Health
505 S PACIFIC AVE, SUITE 201
SAN PEDRO, CA 90731
SAN PEDRO, CA 90731
Chiropractor (Sports Physician)
505 S PACIFIC AVE, STE 104
SAN PEDRO, CA 90731
SAN PEDRO, CA 90731
Counselor (Addiction (Substance Use Disorder))
505 S PACIFIC AVE, SUITE 205
SAN PEDRO, CA 90731
SAN PEDRO, CA 90731
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154199925, enumerated as an "individual" on December 12, 2023.
The provider is located at 505 S PACIFIC AVE SAN PEDRO, CA 90731 and the phone number is (310) 519-8723.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
