Individual
JUSTIN WORTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
58945 BUSINESS CENTER DR, #D, YUCCA VALLEY, CA 92284-7307
(760) 228-9657
Mailing address
3613 SAGE AVE, YUCCA VALLEY, CA 92284-1945
(760) 669-7079
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PCCI1586
CA
Other
Enumeration date
11/21/2013
Last updated
01/28/2015
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