Individual
BIANCA LASHEA PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
835 25TH ST, SAN DIEGO, CA 92102-2738
(619) 239-9691
(619) 239-0909
Mailing address
4437 ESTRELLA AVE, SAN DIEGO, CA 92115-4660
(619) 239-9691
(619) 239-0909
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1624940725
CA
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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