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NPI Code Detail

MEDICARE: STEVEN DERR

MEDICARE: STEVEN DERR
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1528282266
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN DERR
Provider Business Mailing Address
First Line : 8210 S BRIGHT RD
Second Line :
City : FRENCH CAMP
State : CA
Zip : 95231-9759
Country : US
Telephone Number : 209-461-6500
Fax Number :
Provider Business Practice Location Address
First Line : 1117 S GRANT ST
Second Line :
City : STOCKTON
State : CA
Zip : 95206-1626
Country : US
Telephone Number : 209-461-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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Directions to “ STEVEN DERR ” Practice Location

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