Provider Demographics
NPI:1497030365
Name:STRATTON, JEFFERY CHARLES (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:CHARLES
Last Name:STRATTON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5873 CAMBER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4141
Mailing Address - Country:US
Mailing Address - Phone:858-699-3635
Mailing Address - Fax:
Practice Address - Street 1:7777 ALVARADO RD
Practice Address - Street 2:SUITE 269
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-8216
Practice Address - Country:US
Practice Address - Phone:858-699-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 170141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical