Jack Sullivan, MA, MFT

NPI 1528261013 · on the registry since 2007 · sole proprietor

Practice

Address: 8058 La Mesa Blvd.
La Mesa, CA 91942
Phone: (619) 507-8270
Fax: (619) 463-2522
Organisation at this address: Rhombus
Rhombus
Genesis Recovery, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 17

Registry record

Primary taxonomy: 106H00000X
106H00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-11-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California