Individual
ANTAWNY JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CERTIFIED COUNSELOR
Contact information
Practice address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(424) 454-6041
Mailing address
1563 MISSION ST, SAN FRANCISCO, CA 94103-2543
(415) 762-3700
(415) 865-0119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17924
CA
Other
Enumeration date
05/22/2019
Last updated
10/03/2025
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