Provider Demographics
NPI:1962753293
Name:SAHAGUN, JOHN JR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SAHAGUN
Suffix:JR
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 1:307 N OAKLEY AVE
Mailing Address - Street 2:A
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-5911
Mailing Address - Country:US
Mailing Address - Phone:805-287-9227
Mailing Address - Fax:
Practice Address - Street 1:1125 E CLARK AVE
Practice Address - Street 2:STE A2
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5111
Practice Address - Country:US
Practice Address - Phone:808-739-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)