MICHAEL O PENDERGAST RADT NPI 1689239717

NPI Information

  • NPI: 1689239717
  • Provider Name: MICHAEL O PENDERGAST, RADT
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 240 PANORAMA DR
    BENICIA, CA
    ZIP 94510
  • Phone: (707) 712-6317

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NPI Details

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
1101YA0400XCounselorAddiction (Substance Use Disorder)A062410323CALIFORNIAYes

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: 11/21/2025

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