NPI Search for Physicians and Health Care Providers
MR. MICHAEL LEE CHIDESTER CATC-I
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1053973206
Individual Registrant:
MR. MICHAEL LEE CHIDESTER CATC-I
Gender: M
Sole Proprietor
Location and contact information for practice:
6330 THORNTON AVE NEWARK, CA 94560-3734 US
Tel: 510-792-4357 Fax: --
Contact information for business:
6330 THORNTON AVE NEWARK, CA 94560-3734 US
Tel: 510-792-4357 Fax: 510-745-1693
Registration Information:
NPI: 1053973206
Entity Type: Individual
Specialty information:
Primary | Code | Category/Description | State | License Number |
---|
Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | | |
Legacy codes, insurance codes and state license numbers:
Issuer | Number | State | Type |
---|
SUD | 101YA0400X | CA | 01 |
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