Healthcare Provider Details

I. General information

NPI: 1508771601
Provider Name (Legal Business Name): EUGENE DEY CADC III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6933 DRYWOOD WAY
ORANGEVALE CA
95662-2930
US

IV. Provider business mailing address

7344 MAGNOLIA AVE STE 110
RIVERSIDE CA
92504-3819
US

V. Phone/Fax

Practice location:
  • Phone: 951-404-0856
  • Fax: 951-755-8856
Mailing address:
  • Phone: 951-404-0856
  • Fax: 951-755-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberCHW
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number7593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: