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NPI Code Detail

MEDICARE: MR. MILTON JOSEPH DOUCETTE III

MEDICARE: MR. MILTON JOSEPH DOUCETTE III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorCA
2171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CBSC450OTHERCALA DMH PROVIDER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043438054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MILTON JOSEPH DOUCETTE III
Provider Business Mailing Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number :
Provider Business Practice Location Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 04/16/2019

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