Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Justin Wyatt Ciasullo

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1346068624

Justin Wyatt Ciasullo is an Addiction (Substance Use Disorder) Counselor in Upland, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

239 W 9th St
Upland, CA 91786-5979
Phone: (909) 981-6121
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 19137 (CA)

Record details

NPI number1346068624
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 26, 2024
Last updated in NPPESOctober 24, 2024
Certification dateOctober 24, 2024

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