Dennis Mahoney
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Herald, CA
NPI 1154834752 · NPPES record last updated Apr 6, 2023
Key facts
- NPI
- 1154834752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CI32630421 (CA)
- Practice address
- 12490 Alta Mesa Rd
Herald, CA 95638-8409 - Phone
- (209) 748-5073
- NPI assigned
- Nov 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CI32630421 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CI32630421 | CA | Yes |
Addresses
Primary practice location
12490 Alta Mesa Rd
Herald, CA 95638-8409
Mailing address
500 22ND St
Sacramento, CA 95816-3503
Other providers in Herald, CA
- Nicolette R Froehlich
- Aiyana Garcia
- Brendan Higgins
- Robert Bradley Huston Jr.
- Craig Koury
- Corri Elise Martella
- Caterine Michelle Martinez
- Anneta Marie McPhail
- Shawn Noland
- River City Recovery Center
All providers in Herald, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.