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MR. DEMETRIUS JERRELL SUDRC
NPI 1619701018
Counselor - Addiction (Substance Use Disorder) in San Diego, CA

Active since August 28, 2024
6145 IMPERIAL AVE, SAN DIEGO, CA 92114(619) 234-8888 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Demetrius Jerrell Sudrc NPPES

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

MR. DEMETRIUS JERRELL SUDRC (NPI 1619701018) is an individual addiction (substance use disorder) provider in San Diego, California, licensed in California (19181) and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1619701018
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. DEMETRIUS JERRELLCredential: SUDRC
Location Address6145 IMPERIAL AVESan Diego, CA 92114-4213
Mailing Address6145 Imperial AveSan Diego, CA 92114-4213 · (619) 234-8888
Phone(619) 234-8888
Sole ProprietorNo
Enumeration DateAugust 28, 2024
NPPES CertifiedAugust 22, 2024
✔ NPI 1619701018 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
License✔ Licensed in CA · 19181
6145 IMPERIAL AVE, San Diego, CA 92114
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Other Providers at the Same Location NPPES 20

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

SAN DIEGO SECOND CHANCE PROGRAM
Community/Behavioral Health
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 234-8888
LUZ GUADALUPE PORTUGAL
Counselor (Addiction (Substance Use Disorder))
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 234-8888
DAVID ROMO
Case Manager/Care Coordinator
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 839-0939
MR. DANIEL PARADA ESPINOSA
Counselor (Addiction (Substance Use Disorder))
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 234-8888
RAVEN XOCHIQUETZAL SOLTERO
Counselor (Addiction (Substance Use Disorder))
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 234-8888
YADIRA RAMIREZ
Counselor (Addiction (Substance Use Disorder))
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 839-0935
LORI LEIGH WILBORN
Counselor (Addiction (Substance Use Disorder))
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 234-8888
SAMANTHA BELLE GONZALEZ
Counselor (Addiction (Substance Use Disorder))
6145 IMPERIAL AVE
SAN DIEGO, CA 92114
San Diego County (619) 234-8888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Demetrius Jerrell's NPI number?

The NPI number for Demetrius Jerrell is 1619701018. It was assigned to this individual provider in the NPPES registry on August 28, 2024.

Where is Demetrius Jerrell located?

Demetrius Jerrell practices at 6145 Imperial Ave, San Diego, CA 92114. The listed phone number is (619) 234-8888.

What is Demetrius Jerrell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Demetrius Jerrell was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.