MICHAEL O PENDERGAST RADT NPI 1689239717

NPI Information

NPI: 1689239717
Provider Name: MICHAEL O PENDERGAST, RADT
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
240 PANORAMA DR
BENICIA, CA
ZIP 94510
Phone: (707) 712-6317
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Michael O Pendergast, RADT is an addiction (substance use disorder) counselor in Benicia, CA. Michael O Pendergast, RADT NPI is 1689239717. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

240 PANORAMA DR
BENICIA, CA
ZIP 94510-523
Phone: (707) 712-6317

The enumeration date for this NPI number is 5/3/2019 and was last updated on 1/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	A062410323	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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