Alexander Jordan Ty Stull
Alexander Jordan Ty Stull is a Peer Specialist in San Diego, California. Registered with an NPI since 2023.
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
409 Camino Del Rio S Ste 201San Diego, CA 92108-3505
Phone: (619) 381-7748
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community Health Worker (primary) | Taxonomy 172V00000X |
|---|---|
| Peer Specialist | Taxonomy 175T00000X |
Record details
| NPI number | 1790471134 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 17, 2023 |
| Last updated in NPPES | April 27, 2023 |
| Certification date | April 27, 2023 |
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