Doctor Name: | DR. MICHAEL I CALLIS |
NPI Number: | 1104156884 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., MSCP |
License Number: | 19292 |
Business Practice Address: | 4610 Cherry Ave Orcutt, CA - 934553830 |
Business Phone Number: | 8058680471 |
Business Fax Number: | |
Mailing Address: | 4610 Cherry Ave, ORCUTT |
State: | CA |
Postal Code: | 934553830 |
Phone Number: | 8058680471 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2010 |
NPI Last Update Date: | 01/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 19292 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |