Individual
MISS CONNIE MAE MUSARACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CITY STAR ACT / MHS, 8775 AERO DRIVE, SUITE 132, SAN DIEGO, CA 92123-1779
(858) 609-8742
(858) 292-0322
Mailing address
8775 AERO DR STE 132, SAN DIEGO, CA 92123-1779
(858) 609-8742
(858) 292-0322
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/06/2016
Last updated
07/11/2018
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