Derek Michael Sauceda, CATC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

179702 Issued in CA

Practice address

1222 Monaco CT Ste 28
Stockton, CA 95207-6742

Phone

(209) 644-6328

Fax

(209) 644-6308

NPI assigned

Oct 24, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Service First of Northern California

  • Addiction (Substance Use Disorder) Counselor
  • Stockton, CA
  • NPI 1912122250
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1023520590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W BIANCHI RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077132",
            "telephone_number": "209-644-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 MONACO CT STE 28",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076742",
            "telephone_number": "209-644-6328",
            "fax_number": "209-644-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCEDA",
        "first_name": "DEREK",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-24",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "390017AN",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "179702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COURT ORDERED ORSELF PAY",
            "identifier": "390017AN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Satellite Dialysis of South Stockton LLC
• Satellite Dialysis of Stockton LLC
• Bindu Kanathezhath Sathi, M.D.
• Katie Ann Draper Satterfield
• Satya Sol Family Wellness
• Jenaiah La'Neise Sauceda, LCSW
• Adelina Renee Saucedo
• Alejandra Saucedo
• Lena Saucedo
• Gay Lynn Saunders, D.C.

• Addiction (Substance Use Disorder) Counselor in Stockton, CA
• Providers in Stockton, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.