Healthcare Provider Details

I. General information

NPI: 1609199975
Provider Name (Legal Business Name): MARK TODD HUFFORD CADC-II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19531 MCLANE ST. STE. B
PALM SPRINGS CA
92262
US

IV. Provider business mailing address

PO BOX 2651
PALM SPRINGS CA
92263-2651
US

V. Phone/Fax

Practice location:
  • Phone: 760-288-4579
  • Fax: 760-288-3752
Mailing address:
  • Phone: 323-496-1279
  • Fax: 760-288-3752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA3826500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: