Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Demetrius Jerrell, SUDRC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1619701018

Mr. Demetrius Jerrell, SUDRC is an Addiction (Substance Use Disorder) Counselor in San Diego, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

6145 Imperial Ave
San Diego, CA 92114-4213
Phone: (619) 234-8888
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 19181 (CA)

Record details

NPI number1619701018
Entity typeIndividual (Type 1)
GenderMale
Credentials SUDRC
Sole proprietorNo
NPI enumeratedAugust 28, 2024
Last updated in NPPESAugust 28, 2024
Certification dateAugust 22, 2024

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