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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CHARLES JOHNSON ETHELBAH, CMPSS

Active

CHARLES JOHNSON ETHELBAH, CMPSS is a Peer Specialist healthcare provider located in CAMPO, California. NPI 1447125885 is currently active in the NPPES registry. Verify at CMS.

Peer Specialist · CAMPO, CA

Registration Details

NPI Number
1447125885
Provider Type
Individual
Gender
Male
NPI Issued
Oct 7, 2025 (0.82575123532591 yrs)
Last Updated
Oct 7, 2025
License
MPSS-ZKDUCT (CA)

Practice Information

Address
1777 BUCKMAN SPRINGS RD
CAMPO, CA, 919062022
Browse CA providers · Browse ZIP 91906
Phone
6194785696
Primary Specialty
Peer Specialist
175T00000X

Other Peer Specialist Providers in CAMPO, CA

Name Credential NPI
JAMES DAVID ELKINS 1851079248
JOSE DE JESUS VILLA RADT 1528878287
CHRISTOPHER LEE WRIGHT CMPSS 1902789621
TRAVIS HAMBLIN CMPSS 1124904396
ZACHARIAH RYAN BARRETT CMPSS 1326926643
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.