Individual provider Active NPI

Mark Allen Messerer, SUDCC

  • Addiction (Substance Use Disorder) Counselor
  • Martinez, CA
National Provider Identifier
1790841682
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
M0102271028 Issued in CA
Practice address
1220 Morello Ave
Martinez, CA 94553-4707
Phone
(925) 335-3330
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Addiction (Substance Use Disorder) Counselor 101YA0400X M0102271028 CA Primary

Addresses

Primary practice location

1220 Morello Ave
Martinez, CA 94553-4707

Mailing address

97 Gilrix Dr
Martinez, CA 94553-3037
Phone (415) 419-7737

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
M0102271028CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1790841682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GILRIX DR",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945533037",
            "telephone_number": "415-419-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MORELLO AVE",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534707",
            "telephone_number": "925-335-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSERER",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "SUDCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "M0102271028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.