NPIMap

Individual provider Active NPI

David Wayne Deichler, SUDCCII, CSC

  • Addiction (Substance Use Disorder) Counselor
  • Chico, CA
National Provider Identifier
1164779898
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
D0710311220 Issued in CA
Practice address
392 Connors CT Ste C
Chico, CA 95926-1175
Phone
(530) 898-9424
Fax
(530) 898-0239
NPI assigned
Aug 13, 2012
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X D0710311220 CA Primary

Addresses

Primary practice location

392 Connors CT Ste C
Chico, CA 95926-1175

Mailing address

392 Connors CT Ste C
Chico, CA 95926-1175
Phone (530) 898-9424

Other identifiers 2

IdentifierTypeStateIssuer
9195OtherCASUBSTANCE USE DISORDER CERTIFIED COUNSELOR II
D0710311220OtherCACLINICAL SUPERVISOR CREDENTIAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D0710311220CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Skyway House, LLC Past Accepting new patients
Skyway House, Inc. PastSince Jan 12, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1164779898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 CONNORS CT STE C",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261175",
            "telephone_number": "530-898-9424",
            "fax_number": "530-898-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 CONNORS CT STE C",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261175",
            "telephone_number": "530-898-9424",
            "fax_number": "530-898-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEICHLER",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "SUDCCII, CSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "D0710311220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE USE DISORDER CERTIFIED COUNSELOR II",
            "identifier": "9195",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SUPERVISOR CREDENTIAL",
            "identifier": "D0710311220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.