Provider Demographics
NPI:1043414774
Name:WARREN, FRANK ANTHONY
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:ANTHONY
Last Name:WARREN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6037
Mailing Address - Country:US
Mailing Address - Phone:805-545-9656
Mailing Address - Fax:
Practice Address - Street 1:2945 MCMILLAN AVE STE 136
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6774
Practice Address - Country:US
Practice Address - Phone:805-788-2055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)