David Raese, SUDRC15389
David Raese, SUDRC15389 is an Addiction (Substance Use Disorder) Counselor in Modesto, California. Licensed in California. Registered with an NPI since 2023.
- Licensed in
- CA
- In the registry since
- 2023
Practice location Address checks out
1101 Sylvan Ave Ste C103Modesto, CA 95350-1687
Phone: (209) 758-7477
Fax: (866) 875-7351
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence 15389 (CA) |
|---|
Record details
| NPI number | 1760264915 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | SUDRC15389 |
| Sole proprietor | No |
| NPI enumerated | October 20, 2023 |
| Last updated in NPPES | October 20, 2023 |
| Certification date | October 20, 2023 |
| Mailing address | 1101 Sylvan Ave Ste C103, Modesto, CA 95350-1687 |
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