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General NPI Number Information
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NPI Number | 1851422653
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Entity Type | Individual
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Provider Name | RHONDA GAYLE MESENBRINK CADA11
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 424 E HACKETT RD
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City | MODESTO
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State | CA
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Zip | 95358-9493
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Country | US
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Telephone | 209-525-5613
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Fax | 209-525-5655
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Provider Business Mailing Address
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Address Line | 429 OAKSHIRE AVE
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City | MODESTO
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State | CA
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Zip | 95354-1710
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Country | US
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Telephone | 209-525-5613
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Fax | 209-525-5655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A8480203
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License Number State | CA
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