Individual provider · Type 1 NPI

Derik Jamon Everett Sr.

Mental Health Counselor · San Jose, CA

NPI number 1164567442 Active

Practice location

230 No Morrison Ave, Sub Acute Residential Treatment Sart
San Jose, CA 95126-2741

Call (408) 938-8516 Map

Fax (408) 295-4231

Mailing address

2001 The Alameda, Alliance For Community Care
San Jose, CA 95126-1136

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1164567442

Derik Jamon Everett Sr.'s National Provider Identifier is 1164567442, issued on Feb 21, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Jose, CA. The record was last updated on Jul 8, 2007.