Healthcare Provider Details

I. General information

NPI: 1447102512
Provider Name (Legal Business Name): ERIC DELGADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 CHRISTOPHER CT
RIDGECREST CA
93555-6009
US

IV. Provider business mailing address

209 S GREENLAWN ST
RIDGECREST CA
93555-4224
US

V. Phone/Fax

Practice location:
  • Phone: 760-800-4325
  • Fax: 760-239-7601
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: