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NPI Code Detail

MEDICARE: DENICIA ROYCHELE CORMIER

MEDICARE: DENICIA ROYCHELE CORMIER
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 Counselor

Other Identifiers

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

General Provider Information

NPI Number : 1467741280
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENICIA ROYCHELE CORMIER
Provider Business Mailing Address
First Line : 2325 CLEMENT AVE
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-7061
Country : US
Telephone Number : 510-629-6300
Fax Number :
Provider Business Practice Location Address
First Line : 2325 CLEMENT AVE
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-7061
Country : US
Telephone Number : 510-629-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2011
Last Update Date : 04/01/2011

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Directions to “ DENICIA ROYCHELE CORMIER ” Practice Location

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