MR. CARLOS DE LA CERDA
NPI 1972636603
Counselor - Addiction (Substance Use Disorder) in Modesto, CA
Active since March 13, 2007
About Mr. Carlos De La Cerda NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. CARLOS DE LA CERDA (NPI 1972636603) is an individual addiction (substance use disorder) provider in Modesto, California, licensed in California (A0683425) and active in the NPI registry since March 2007.
NPPES Registry Identity
NPI1972636603
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. CARLOS DE LA CERDA
Location Address2800 BRADEN AVE # 321Modesto, CA 95356-0648
Mailing Address2800 Braden Ave # 321Modesto, CA 95356-0648 · (209) 404-2101
Phone(209) 404-2101
Sole ProprietorYes
Enumeration DateMarch 13, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1972636603 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 · A0683425
2800 BRADEN AVE # 321, Modesto, CA 95356
Other Names 1
Former Name (1)Mr. Charles De La Cerda
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972636603, enumerated as an "individual" on March 13, 2007.
The provider is located at 2800 BRADEN AVE # 321 MODESTO, CA 95356 and the phone number is (209) 404-2101.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
