BECK JOLLY (NPI# 1417441072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417441072 |
| Entity Type | Individual |
| Full Name | BECK JOLLY |
| Credential | CCAPP |
| Practice Address |
5855 Streamview Dr San Diego CA 92105 |
| Mailing Address |
2901 Broadway San Diego CA 92102-2294 |
| Practice Telephone | 6192875460 |
| Mailing Telephone | 6197889258 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CA | Behavioral Health & Social Service Providers | |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
12405-R | CA | Behavioral Health & Social Service Providers |
| Street Address |
5855 STREAMVIEW DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881723344 | The Twelfth Step House of San Diego, Inc. | Substance Abuse Rehabilitation Facility | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2007-03-02 |
| 1487253399 | David James Neal | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2020-10-21 |
| 1942839865 | Claudette Lashawne Coleman | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2020-04-02 |
| 1578100582 | Miranda Dinkins | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2019-12-09 |
| 1487205886 | Kyle Nicholas Harman | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2019-09-26 |
| 1699326405 | Curtis Robert Quay | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2019-09-23 |
| 1265083299 | Michael Anthony Nunez | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2019-09-20 |
| 1710443288 | William Allen Mccarty | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2019-02-20 |
| 1346734969 | Jon Karmazin | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2018-06-18 |
| 1902390578 | Keith Puckett | Counselor | 5855 Streamview Dr, San Diego, CA 92105-3910 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934798 | Point Loma Nazarene University | Nurse Practitioner | Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 | 2019-10-23 |
| 1104478809 | Kristin Lynn Nichols | Counselor | 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 | 2019-07-12 |
| 1205343076 | Momentum Learning | Counselor | 3720 El Cajon Blvd., Sd, CA 92105 | 2018-01-03 |
| 1306352695 | Nathan Hien Le, Dds. Inc | Dentist | 4170 Fairmount Ave., San Diego, CA 92105 | 2017-12-21 |
| 1073038071 | Aika Mary Erlandson | Student in an Organized Health Care Education/Training Program | 5296 University Ave. Suite F-2, San Diego, CA 92105 | 2017-08-10 |
| 1457872178 | Ride-in Transport LLC | Non-emergency Medical Transport (VAN) | 4061 Fairmount Ave, San Diego, CA 92105 | 2017-07-03 |
| 1598205346 | Ahmed Mooge | Ambulance | 4061 Fairmout Ave, San Diego, CA 92105 | 2017-02-27 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| Find all providers in zip 92105 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1477166734 | Laura Aida Andrade | Counselor | 4125 Wabash Ave, San Diego, CA 92104-2124 | 2020-08-26 |
| 1679113096 | David Salvador Avalos | Counselor | 3642 Rosa Linda St, San Diego, CA 92154-3653 | 2020-01-14 |
| 1023651692 | Robert Joseph Kassel | Counselor | 6551 Seaman St, San Diego, CA 92120-2629 | 2019-10-25 |
| 1609437979 | Pamela Lynette Hill | Counselor | 3960 W Point Loma Blvd, San Diego, CA 92110-5643 | 2019-06-26 |
| 1154989838 | Victoria Philips | Counselor | 4055 58th St Apt 10, San Diego, CA 92115-6209 | 2019-05-29 |
| 1740847375 | Jessica Cristina Williams | Counselor | 1775 Elm Ave, San Diego, CA 92154-1104 | 2019-05-20 |
| 1659934164 | Virginia Denise Mcswain | Counselor | 220 Euclid Ave Ste 200, San Diego, CA 92114-3644 | 2019-04-19 |
| 1386107324 | Connie Padera | Counselor | 3148 Midway Dr # 113, San Diego, CA 92110-4539 | 2019-04-08 |
| 1154891067 | Vincent Garside | Counselor | 2516 A Sreet, San Diego, CA 92102-9210 | 2018-12-04 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.