Gerrod Herndon, SUDRC15464
Gerrod Herndon, SUDRC15464 is a Substance Use Disorder Rehabilitation Clinic/Center in San Rafael, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2023
Practice location Address checks out
603 D StSan Rafael, CA 94901-3719
Phone: (707) 331-5575
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Substance Use Disorder Rehabilitation Clinic/Center (primary) | Taxonomy 261QR0405X · Licence 15464 (CA) |
|---|
Record details
| NPI number | 1689368615 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | SUDRC15464 |
| Sole proprietor | Yes |
| NPI enumerated | June 5, 2023 |
| Last updated in NPPES | June 5, 2023 |
| Certification date | June 4, 2023 |
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