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1710182977

NPI Code Detail

MEDICARE: CARLOS J PADILLA

MEDICARE: CARLOS J PADILLA

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

General Provider Information

NPI Number	:	1710182977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS J PADILLA

Provider Business Mailing Address
First Line	:	PO BOX 5487
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94524-0487
Country	:	US
Telephone Number	:	925-672-5700
Fax Number	:	925-672-1374

Provider Business Practice Location Address
First Line	:	11540 MARSH CREEK RD
Second Line	:
City	:	CLAYTON
State	:	CA
Zip	:	94517-9759
Country	:	US
Telephone Number	:	925-672-5700
Fax Number	:	925-672-1374

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	07/08/2007

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Directions to “ CARLOS J PADILLA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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