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General NPI Number Information
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NPI Number | 1881163434
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Entity Type | Individual
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Provider Name | JAMES DEAN ANDERS CADC-LL
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Gender | Male
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 14340 ELSWORTH ST STE 108
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City | MORENO VALLEY
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State | CA
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Zip | 92553-9020
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Country | US
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Telephone | 951-653-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 4113 WILSON ST SPACE 64
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City | BANNING
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State | CA
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Zip | 92220
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Country | US
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Telephone | 951-660-3497
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Fax |
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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 | A044530517
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License Number State | CA
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