Individual
ANDREW KENNETH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
2952 CEDAR ST, SAN DIEGO, CA 92102-1515
(619) 239-7370
Mailing address
2952 CEDAR ST, SAN DIEGO, CA 92102-1515
(619) 239-7370
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RT1419840925
CA
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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