Provider Demographics
NPI:1376229377
Name:WATTS, GERAL ULYSSES II
Entity Type:Individual
Prefix:MR
First Name:GERAL
Middle Name:ULYSSES
Last Name:WATTS
Suffix:II
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 1:1224 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-3150
Mailing Address - Country:US
Mailing Address - Phone:909-810-9346
Mailing Address - Fax:
Practice Address - Street 1:1224 OHIO ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-3150
Practice Address - Country:US
Practice Address - Phone:909-810-9346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician