Individual
MR. BOBBY LEE TAUNTON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC-II, ICADC
Contact information
Practice address
1539 CAROLYN CT, REDLANDS, CA 92374-4738
(909) 413-4304
Mailing address
870 AARON DR, REDLANDS, CA 92374-3811
(334) 799-9186
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A049920618
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A049920618
CCAPP
CA
Enumeration date
11/19/2018
Last updated
09/19/2023
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