| Doctor Name: | MR. JOHN ODDEN |
| NPI Number: | 1942546668 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RSCP |
| License Number: | |
| Business Practice Address: | 31982 Via Coyote Trabuco Canyon, CA - 926794109 |
| Business Phone Number: | 9497135500 |
| Business Fax Number: | 9497135501 |
| Mailing Address: | 31982 Via Coyote, TRABUCO CANYON |
| State: | CA |
| Postal Code: | 926794109 |
| Phone Number: | 9497135500 |
| Fax Number: | 9497135501 |
| NPI Enumeration Date: | 12/28/2012 |
| NPI Last Update Date: | 12/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |