Individual provider · Type 1 NPI
Gerrod Herndon, SUDRC #15464
Substance Use Disorder Rehabilitation Clinic/Center · San Rafael, CA
NPI number
1689368615
Active
Practice location
603 D St
San Rafael, CA 94901-3719
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 15464 (CA) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
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About NPI 1689368615
Gerrod Herndon, SUDRC #15464's National Provider Identifier is 1689368615, issued on Jun 5, 2023. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in San Rafael, CA. The record was last updated on Jun 5, 2023.