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NPI Code Detail

MEDICARE: DEYLA ANDERSON CAODC

MEDICARE: DEYLA ANDERSON CAODC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1588120299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEYLA ANDERSON CAODC
Provider Business Mailing Address
First Line : 601 E FLORIDA AVE
Second Line :
City : HEMET
State : CA
Zip : 92543-4335
Country : US
Telephone Number : 951-391-1470
Fax Number :
Provider Business Practice Location Address
First Line : 109 E 11TH ST
Second Line :
City : CORONA
State : CA
Zip : 92879-2157
Country : US
Telephone Number : 951-427-3482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2019
Last Update Date : 08/02/2023

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Directions to “ DEYLA ANDERSON CAODC” Practice Location

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