MR. RAYMOND EDWARD DOUGLAS SUDCC III
NPI 1407317704
Counselor - Addiction (Substance Use Disorder) in Fremont, CA

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

Active since March 28, 2019

37437 GLENMOOR DR, FREMONT, CA 94536(510) 713-3200(510) 713-0684 Get Directions Write a Review

NPPES record last updated: March 16, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 16, 2026, Sep 30, 2024, Sep 8, 2022 (3 updates tracked since 2022).

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About Mr. Raymond Edward Douglas Sudcc Iii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RAYMOND EDWARD DOUGLAS SUDCC III (NPI 1407317704) is an individual addiction (substance use disorder) provider in Fremont, California, licensed in California (19319) and active in the NPI registry since March 2019.

NPPES Registry Identity

NPI1407317704

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. RAYMOND EDWARD DOUGLASCredential: SUDCC III

Location Address37437 GLENMOOR DRFremont, CA 94536-5731

Mailing Address4510 Peralta Blvd Ste 1Fremont, CA 94536-5755 · (510) 713-3202 · Fax (510) 713-0684

Phone(510) 713-3200

Fax(510) 713-0684

Sole ProprietorNo

Enumeration DateMarch 28, 2019

Last NPPES UpdateMarch 16, 20263 updates tracked since enumeration

NPPES CertifiedMarch 16, 2026

✔ NPI 1407317704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

Licenses✔ Licensed in CA · 19319✔ Licensed in CA · R1326931018✔ Licensed in CA · A058430920

37437 GLENMOOR DR, Fremont, CA 94536

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Other Identifiers 1

OtherA058430920CA · Ccapp

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARNELES UNIDOS REFORMANDO ADICTOS INCORPORATE

Substance Abuse Rehabilitation Facility