Provider Demographics
NPI:1447539192
Name:MOBLEY, VERA LEE
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:LEE
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 HIGHLAND AVE.
Mailing Address - Street 2:208
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:91950
Mailing Address - Country:US
Mailing Address - Phone:619-581-5515
Mailing Address - Fax:
Practice Address - Street 1:2525 HIGHLAND AVE
Practice Address - Street 2:208
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7004
Practice Address - Country:US
Practice Address - Phone:619-581-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)