Active NPI
John Dennem
- Addiction (Substance Use Disorder) Counselor
- Inglewood, CA
National Provider Identifier
1659775302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- A8571212
- Practice address
- 323 N. Praire Ave.
Inglewood, CA 90301 - Phone
- (310) 846-2100
- Fax
- (310) 846-2139
- NPI assigned
- Oct 9, 2014
- Sex
- Male
- Sole proprietor
- No
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 | A8571212 | CA | Primary |
Addresses
Primary practice location
323 N. Praire Ave.
Inglewood, CA 90301
Mailing address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612
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 |
|---|---|---|---|
| A8571212 | 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": "1412812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412812800000",
"number": "1659775302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 N. PRAIRE AVE.",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "90301",
"telephone_number": "310-846-2100",
"fax_number": "310-846-2139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNEM",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-09",
"last_updated": "2014-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "A8571212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inglewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.