Provider Demographics
NPI:1104944586
Name:ACEDO, VICTOR MESSINA (CADCII)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:MESSINA
Last Name:ACEDO
Suffix:
Gender:M
Credentials:CADCII
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3635 RUFFIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1853
Mailing Address - Country:US
Mailing Address - Phone:858-300-0460
Mailing Address - Fax:858-300-0461
Practice Address - Street 1:10159 MISSION GORGE RD
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3857
Practice Address - Country:US
Practice Address - Phone:760-227-1380
Practice Address - Fax:619-588-6282
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01-042565101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)