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MICHAEL JONATHAN DEMMERS
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1912486267
Individual Registrant: MICHAEL JONATHAN DEMMERS
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
40 E MINARETS AVE PINEDALE, CA 93650-1239 US
Tel: 559-436-0482 Fax: 844-587-6403
Tel: 559-436-0482 Fax: 844-587-6403
Contact information for business:
40 E MINARETS AVE PINEDALE, CA 93650-1239 US
Tel: 559-436-0482 Fax: 844-587-6403
Tel: 559-436-0482 Fax: 844-587-6403
Registration Information:
NPI: 1912486267
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | ||
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
