Provider Demographics
NPI:1619636842
Name:KESSLER, DUSTIN HAYES (AMFT, CADC-III)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:HAYES
Last Name:KESSLER
Suffix:
Gender:M
Credentials:AMFT, CADC-III
Other - Prefix:
Other - First Name:DUSTY
Other - Middle Name:
Other - Last Name:WHITEWATER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2178 ABBOTT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-2056
Mailing Address - Country:US
Mailing Address - Phone:760-688-8636
Mailing Address - Fax:
Practice Address - Street 1:4058 WILLOWS RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-1668
Practice Address - Country:US
Practice Address - Phone:619-445-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABII00310720101YA0400X
CA135986106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)