Provider Demographics
NPI:1447776901
Name:MCKINLEY, JOHN ANTONIO
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ANTONIO
Last Name:MCKINLEY
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 1:234 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2716
Mailing Address - Country:US
Mailing Address - Phone:415-544-8444
Mailing Address - Fax:
Practice Address - Street 1:234 EDDY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2716
Practice Address - Country:US
Practice Address - Phone:415-544-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$OtherCASE MANAGMENT