Samantha Dennison, CADC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A04930315 Issued in CA

Practice address

565 Chaney St
Lake Elsinore, CA 92530-2722

Phone

(951) 674-5354

Fax

(951) 674-5227

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1245356740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 WISCONSIN ST",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959286266",
            "telephone_number": "530-804-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 CHANEY ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302722",
            "telephone_number": "951-674-5354",
            "fax_number": "951-674-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "SAMANTHA",
        "credential": "CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C.A.S.",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A04930315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delago Pharamacy Inc
• Matthew Delano
• Johnny Delgado
• Delta Drugs II, Inc.
• Craig Demers
• Dental Office of Albert Rincon DDS Inc.
• Derek B. Hauser, DDS, Inc.
• Mark Peter Desjardins, B. ED
• John Paul Devries, MFT
• Brenda Diaz

• Addiction (Substance Use Disorder) Counselor in Lake Elsinore, CA
• Providers in Lake Elsinore, 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 Dec 29, 2022; 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.