Individual
BECK JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCAPP
Contact information
Practice address
5855 STREAMVIEW DR, SAN DIEGO, CA 92105
(619) 287-5460
Mailing address
2901 BROADWAY, SAN DIEGO, CA 92102-2294
(619) 788-9258
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12405-R
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Enumeration date
06/18/2018
Last updated
08/31/2018
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