Individual
ALDEN LEE BLIZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
995 GATEWAY CENTER WAY STE 300, SAN DIEGO, CA 92102-4550
(619) 398-2156
Mailing address
995 GATEWAY CENTER WAY STE 300, SAN DIEGO, CA 92102-4550
(619) 750-8497
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
R4280115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
TREATMENT COUNSELOR
CA
Enumeration date
10/21/2014
Last updated
11/23/2020
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