Individual
MR. JOSEPH M CONCELLOSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3320 KEMPER ST, SUITE 104, SAN DIEGO, CA 92110-4903
(619) 758-6205
(619) 752-6209
Mailing address
3320 KEMPER ST, SUITE 104, SAN DIEGO, CA 92110-4903
(619) 758-6205
(619) 752-6209
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCS13561
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCS13561
LCSW LICENSE
CA
Enumeration date
03/22/2007
Last updated
07/08/2007
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