Healthcare Provider Details

I. General information

NPI: 1760929749
Provider Name (Legal Business Name): DANNY ALDRIDGE C.A.T.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24885 WHITEWOOD RD STE 105
MURRIETA CA
92563-2004
US

IV. Provider business mailing address

24885 WHITEWOOD RD STE 105
MURRIETA CA
92563-2004
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-8558
  • Fax: 951-698-8883
Mailing address:
  • Phone: 951-698-8558
  • Fax: 951-698-8883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: