Individual provider Active NPI

Samantha Rae Dehn, SUDRC

  • Addiction (Substance Use Disorder) Counselor
  • Stockton, CA
National Provider Identifier
1487470944
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
39007BN Issued in CA
Practice address
1981 Cherokee Rd
Stockton, CA 95205-2720
Phone
(209) 870-6500
NPI assigned
Dec 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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 39007BN CA Primary

Addresses

Primary practice location

1981 Cherokee Rd
Stockton, CA 95205-2720

Mailing address

1981 Cherokee Rd
Stockton, CA 95205-2720
Phone (209) 870-6500

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
39007BNCAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alcohol & Drug Awareness Program CurrentSince Dec 8, 2024 Accepting new patients
Alcohol & Drug Awareness Program PastSince Dec 8, 2024 Accepting new patients

Locations

1981 Cherokee Rd
Stockton, CA 95205
Phone (209) 817-6500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1487470944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 CHEROKEE RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952052720",
            "telephone_number": "209-870-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 CHEROKEE RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952052720",
            "telephone_number": "209-870-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHN",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "credential": "SUDRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "39007BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.