Jeanette Demedenko

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

22359 Issued in CA

Practice address

10936 Dale Ave
Stanton, CA 90680-2724

Phone

(714) 952-4032

Fax

(714) 952-4075

NPI assigned

Aug 18, 2025

Sex

Female

Sole proprietor

Yes

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.

• Roque Center, Inc

  • Substance Abuse Rehabilitation Facility
  • Stanton, CA
  • NPI 1689772170
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 18, 2025.

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1992682546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10936 DALE AVE",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906802724",
            "telephone_number": "714-952-4032",
            "fax_number": "714-952-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10936 DALE AVE",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906802724",
            "telephone_number": "714-952-4032",
            "fax_number": "714-952-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMEDENKO",
        "first_name": "JEANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "22359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David De Rosas
• Elizabeth De Rosas
• Dean Tran, D.O., Inc
• Ashlyn Deguzman
• Jacque Paige Deleo, RASI
• Ryan Deslauriers, RBT
• Korrina Despain
• Genesis Gabriela Diaz-Espique
• Christine Dinh, PHARMD
• Kristy Dinh

• All providers in Stanton, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.