Charles Johnson Ethelbah, CMPSS
NPI #1447125885 in Campo, California
Provider Information
- NPI Number
- 1447125885
- Entity Type
- Individual
- Name
- Charles Johnson Ethelbah, CMPSS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Peer Specialist
- Credential
- CMPSS
- Enumeration Date
- Oct 7, 2025
- Last Updated
- Oct 7, 2025
Practice Location
- Address
- 1777 BUCKMAN SPRINGS RD
- City
- Campo
- State
- California
- ZIP Code
- 91906-2022
- Phone
- (619) 478-5696
Specialties & Taxonomy Codes
| Specialty |
|---|
| Peer Specialist |
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