Provider Demographics
NPI:1104460732
Name:GACHUPIN, JOHN STEVE (CADC-II)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVE
Last Name:GACHUPIN
Suffix:
Gender:M
Credentials:CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 PAPIN STREET
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-2237
Mailing Address - Country:US
Mailing Address - Phone:760-277-8502
Mailing Address - Fax:
Practice Address - Street 1:2300 E 7TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2852
Practice Address - Country:US
Practice Address - Phone:619-791-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAII31470819101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)