Individual
MR. CEDRIC ANTRON STATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
2525 CAMINO DEL RIO S STE 313, SAN DIEGO, CA 92108-3784
(442) 322-8143
(619) 598-0594
Mailing address
2772 PIANTINO CIR, SAN DIEGO, CA 92108-4736
(704) 492-9595
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11040
CA
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPCC11040
CALIFORNIA BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
12/08/2021
Last updated
03/27/2022
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