Kisner, Mark Ronald

Kisner, Mark Ronald is an sole proprietor health care provider with primary practice located at 316 Thalia St , Laguna Beach CA 92651-2714. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Kisner, Mark Ronald can be contacted via phone (714) 913-0852.

Contact Information

Primary practice address
316 Thalia St Laguna Beach CA 92651-2714
Phone: (714) 913-0852
Fax: (949) 497-3687
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X RA851306 California

Profile Details

NPI number 1922257484
LBN Legal business name Kisner, Mark Ronald
Credentials MSW, CADC-II
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2008
Last updated Sep 9th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922257484 NPPES
California Other RA851306 CERTIFICATION BOARD OF ALCOHOL AND DRUG COUNSELORS

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