Fortune, Terrell Jason

Fortune, Terrell Jason is an sole proprietor health care provider with primary practice located at 720 S. B St. , San Mateo CA 94401. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Fortune, Terrell Jason can be contacted via phone (650) 579-7157.

Contact Information

Primary practice address
720 S. B St. San Mateo CA 94401
Phone: (650) 579-7157
Fax: (650) 579-5530
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1720349731
LBN Legal business name Fortune, Terrell Jason
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2012
Last updated Jun 6th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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