Provider Demographics
NPI:1437288446
Name:KUA, JOHN K III (CAARR)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:K
Last Name:KUA
Suffix:III
Gender:M
Credentials:CAARR
Other - Prefix:
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Mailing Address - Street 1:3721 ARIZONA ST
Mailing Address - Street 2:APT. A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-3326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3928 ILLINOIS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-3058
Practice Address - Country:US
Practice Address - Phone:619-515-2424
Practice Address - Fax:619-255-4174
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)