MICHAEL ANDREW DEJU (NPI# 1710485842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710485842 |
| Entity Type | Individual |
| Full Name | MICHAEL ANDREW DEJU |
| Practice Address |
634 Pressley St Santa Rosa CA 95404-5526 |
| Practice Telephone | 7075736955 |
| Practice Fax Number | 7075438176 |
| Mailing Telephone | 7075736955 |
| Mailing Fax Number | 7075438176 |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1366820979 | 05 |
| Street Address |
634 PRESSLEY ST |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-5526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831219989 | Community Suppport Network | Community Based Residential Treatment Facility, Mental Illness | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2007-03-30 |
| 1356958540 | Dustin Phillips | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2020-09-30 |
| 1861005761 | David Lang | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2020-08-28 |
| 1679181259 | Christina Ellen Gillion | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2020-07-20 |
| 1245858331 | Kaela Patricia O'brien | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2020-07-06 |
| 1124659990 | Katherine Kellie Slater | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2020-01-30 |
| 1720625056 | Thomas Richard Hanson | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2019-12-05 |
| 1932615812 | Michael Harold Nunnally | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2017-12-14 |
| 1407365968 | Randi Adriana Withers | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2017-09-27 |
| 1639691231 | Angela Ward | Counselor | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2017-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1730710260 | Harold Joseph Bahr | Counselor | 1550 N Dutton Ave, Santa Rosa, CA 95401-4601 | 2020-02-03 |
| 1801432398 | William Carroll | Counselor | 1260 N Dutton Ave Ste 185, Santa Rosa, CA 95401-7146 | 2019-11-20 |
| 1497390462 | Emily Sue Hamp | Counselor | 1202 Woodlake Dr, Santa Rosa, CA 95405-9217 | 2019-11-13 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1174005540 | Amal Saeed Ahmed | Counselor | 2908 Bay Village Cir Apt 2108, Santa Rosa, CA 95403-3611 | 2018-09-03 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1992223192 | Jill Mcculloch | Counselor | 300 Stony Point Rd Apt 190, Santa Rosa, CA 95401-5960 | 2017-09-07 |
| 1497299325 | Janice Anne Myers | Counselor | 3746 Oregon Dr, Santa Rosa, CA 95405-7136 | 2016-12-12 |
| 1689128001 | Wakanda Rose | Counselor | 254 Brey Rd, Santa Rosa, CA 95409-5556 | 2016-08-15 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
Please comment or provide details below to improve the information on MICHAEL ANDREW DEJU.
| 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.