Active NPI
Brett Diettinger
- Addiction (Substance Use Disorder) Counselor
- Santa Maria, CA
National Provider Identifier
1245757434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1335631
- Practice address
- 1414 S Miller St
Santa Maria, CA 93454-6923 - Phone
- (805) 739-1512
- NPI assigned
- Aug 28, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1335631 | CA | Primary |
Addresses
Primary practice location
1414 S Miller St
Santa Maria, CA 93454-6923
Mailing address
1414 S Miller St
Santa Maria, CA 93454-6923
Phone (805) 739-1512
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1335631 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1245757434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 S MILLER ST",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546923",
"telephone_number": "805-739-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 S MILLER ST",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546923",
"telephone_number": "805-739-1512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETTINGER",
"first_name": "BRETT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "1335631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.