Provider Demographics
NPI:1790843761
Name:PURLEY, RON CHRISTIAN (BA)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:CHRISTIAN
Last Name:PURLEY
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5544 BALBOA ARMS DR
Mailing Address - Street 2:A6
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5077
Mailing Address - Country:US
Mailing Address - Phone:858-278-1944
Mailing Address - Fax:
Practice Address - Street 1:5544 BALBOA ARMS DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-5077
Practice Address - Country:US
Practice Address - Phone:858-278-1944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health