Provider Demographics
NPI:1801390935
Name:CONEN, JOHN J SR (CADC-CAS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:CONEN
Suffix:SR
Gender:M
Credentials:CADC-CAS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2516 A ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2111
Mailing Address - Country:US
Mailing Address - Phone:619-235-0592
Mailing Address - Fax:619-235-0593
Practice Address - Street 1:2516 A ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-2111
Practice Address - Country:US
Practice Address - Phone:619-235-0592
Practice Address - Fax:619-235-0593
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)