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NPI Code Detail

MEDICARE: ANTHONY O NEGRETE

MEDICARE:   ANTHONY O NEGRETE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorAII11521215CA

General Provider Information

NPI Number : 1366755183
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY O NEGRETE
Provider Business Mailing Address
First Line : 14515 HAMLIN ST STE 100
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-1694
Country : US
Telephone Number : 818-485-1900
Fax Number : 818-782-3384
Provider Business Practice Location Address
First Line : 14515 HAMLIN ST STE 100
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-1694
Country : US
Telephone Number : 818-485-1900
Fax Number : 818-782-3384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2010
Last Update Date : 03/21/2025

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Directions to “ ANTHONY O NEGRETE ” Practice Location

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