Sudduth, Justin Wally

Sudduth, Justin Wally is an sole proprietor health care provider with primary practice located at 720 Wood St , Eureka CA 95501-4413. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Community Health Worker, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Sudduth, Justin Wally can be contacted via phone (707) 268-2990.

Contact Information

Primary practice address
720 Wood St Eureka CA 95501-4413
Phone: (707) 268-2990
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Community Health Worker 172V00000X California
Other Service Providers / Community Health Worker 172V00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1467726992
LBN Legal business name Sudduth, Justin Wally
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 1st, 2012
Last updated May 18th, 2021 - about 3 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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