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1164378188

NPI Code Detail

MEDICARE: JOSEPH DAVID EMERSON SUDRC I

MEDICARE: JOSEPH DAVID EMERSON SUDRC I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	24062	CA

General Provider Information

NPI Number	:	1164378188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH DAVID EMERSON SUDRC I

Provider Business Mailing Address
First Line	:	1397 STONEHEDGE DR
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-1033
Country	:	US
Telephone Number	:	925-798-7250
Fax Number	:

Provider Business Practice Location Address
First Line	:	11540 MARSH CREEK RD
Second Line	:
City	:	CLAYTON
State	:	CA
Zip	:	94517-9759
Country	:	US
Telephone Number	:	925-798-7250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ JOSEPH DAVID EMERSON SUDRC I” Practice Location

Language	Start Address	Practice Location

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