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Individual

BENJAMIN KETTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7986 DAGGET ST, SAN DIEGO, CA 92111-2321
(858) 300-0460
Mailing address
7986 DAGGET ST, SAN DIEGO, CA 92111-2321

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Enumeration date
10/25/2017
Last updated
04/07/2025
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