MR. DEREK MICHAEL SAUCEDA (NPI# 1023520590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023520590 |
Entity Type | Individual |
Full Name | MR. DEREK MICHAEL SAUCEDA |
Credential | CATC |
Practice Address |
1222 Monaco Ct Ste 28 Stockton CA 95207-6742 |
Mailing Address |
102 W Bianchi Rd Stockton CA 95207-7132 |
Practice Telephone | 2096446328 |
Practice Fax Number | 2096446308 |
Mailing Telephone | 2096446319 |
Enumeration Date | 2017-10-24 |
Last Update Date | 2018-06-16 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
390017AN | CA | Behavioral Health & Social Service Providers |
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
179702 | CA | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | COURT ORDERED ORSELF PAY | 390017AN | 01 |
Street Address |
1222 MONACO CT STE 28 |
City | STOCKTON |
State | CA |
Zip Code | 95207-6742 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417593864 | John Mattthew Ilonummi | Counselor | 1222 Monaco Ct Ste 28, Stockton, CA 95207-6742 | 2019-11-20 |
1346749918 | Janice Gerhart | Counselor | 1222 Monaco Ct Ste 28, Stockton, CA 95207-6742 | 2018-02-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669004438 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1002 Robinhood Drive, Stockton, CA 95207 | 2020-02-10 |
1811533110 | Tanya V Jones | Dental Hygienist | Community Medical Centers, 83 W. March Ln., Stockton, CA 95207 | 2019-11-21 |
1053966358 | Ingrid Marcela Saavedra | Behavioral Analyst | 1545 Saint Marks Plaza Ste 9, Stockton, CA 95207 | 2019-08-05 |
1497218861 | Turning Point Community Programs | Community/Behavioral Health | 1803 W March Ln Ste C-d, Stockton, CA 95207 | 2019-04-11 |
1427510627 | Stockton Sleep Center Inc | Physiological Laboratory | 1545 Saint Marks Plaza, Suite 2, Stockton, CA 95207 | 2019-04-05 |
1518436229 | Nicolas Anthony Overby | Occupational Therapist | Windsor Elmhaven Care Cente 6940 Pacific Ave, Stockton, CA 95207 | 2018-11-26 |
1912475724 | Ashley Johnson | Behavior Technician | 87 W. March Ln. Suite 6, Stockton, CA 95207 | 2018-11-09 |
1124596085 | Korie Cottrell | Behavior Technician | 87 W. March Ln., Suite 6, Stockton, CA 95207 | 2018-11-08 |
1760979645 | Maria Esther Rodriguez | Counselor | 2425 W March Ln., Stockton, CA 95207 | 2018-04-17 |
1902301161 | Lashray Elliott | Behavior Technician | 2291 W. Mach Lane, Ste C101, Stockton, CA 95207 | 2018-03-28 |
Find all providers in zip 95207 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740893155 | Tracey Black | Counselor | 130 W Flora St, Stockton, CA 95202-1636 | 2020-08-25 |
1699305508 | Juan Robles | Counselor | 1947 N California St # 95204, Stockton, CA 95204-6029 | 2020-01-20 |
1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
1821648353 | Kaye Lynn Scott-roy | Counselor | 285 H Rd, Stockton, KS 67669-8889 | 2019-09-17 |
1760049043 | Jay Frank Williams | Counselor | 1105 N El Dorado St, Stockton, CA 95202-1305 | 2019-05-22 |
1184105462 | Rachelle Diane Wilson | Counselor | 2733 N Sutter St, Stockton, CA 95204-4548 | 2018-08-24 |
1568943835 | Heather Lynn Rogers | Counselor | 3990 Black Butte Cir, Stockton, CA 95209-3500 | 2018-08-24 |
1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
1760995781 | Dana Lamont Harris | Counselor | 2833 Buckner Ct, Stockton, CA 95207-2302 | 2017-11-13 |
Find all providers in STOCKTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.