Individual
NATHAN SHAW WENTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1733 EUCLID AVE, SAN DIEGO, CA 92105-5414
(619) 263-0433
(619) 263-3992
Mailing address
872 DELGADO PL, ESCONDIDO, CA 92025-5666
(161) 975-6153
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/14/2022
Last updated
06/13/2022
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