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NPI Code Detail

MEDICARE: DERRICK BRESSEL

MEDICARE: DERRICK BRESSEL
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) Counselor

General Provider Information

NPI Number : 1386779569
Entity Type Code : Individual
Provider Name (Legal Business Name) : DERRICK BRESSEL
Provider Business Mailing Address
First Line : 1891 S WAVERLY LN
Second Line :
City : FRESNO
State : CA
Zip : 93727-6134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 611 E BELMONT AVE
Second Line :
City : FRESNO
State : CA
Zip : 93701-1502
Country : US
Telephone Number : 559-237-3420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 09/22/2014

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Directions to “ DERRICK BRESSEL ” Practice Location

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