Dedomenico, John Anthony

Dedomenico, John Anthony is an individual health care provider with primary practice located at 2020 Blake St , Berkeley CA 94704. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Dedomenico, John Anthony can be contacted via phone (415) 746-1967.

Contact Information

Primary practice address
2020 Blake St Berkeley CA 94704
Phone: (415) 746-1967
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X MFC 30336 California

Profile Details

NPI number 1326194911
LBN Legal business name Dedomenico, John Anthony
Credentials M.S. MFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326194911 NPPES
California Other 30097 BIS

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