Provider Demographics
NPI:1881871127
Name:GIRDLER, JOHN CAMPBELL
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CAMPBELL
Last Name:GIRDLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10162 RAINBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-7623
Mailing Address - Country:US
Mailing Address - Phone:760-458-2677
Mailing Address - Fax:
Practice Address - Street 1:10162 RAINBROOK DR
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-7623
Practice Address - Country:US
Practice Address - Phone:760-458-2677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)