MR. MARK PETER DESJARDINS (NPI# 1578944161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578944161 |
| Entity Type | Individual |
| Full Name | MR. MARK PETER DESJARDINS |
| Credential | B. ED |
| Practice Address |
265 San Jacinto River Rd Ste 107 Lake Elsinore CA 92530-4400 |
| Practice Telephone | (951) 674-9243 |
| Practice Fax Number | 9516749635 |
| Mailing Telephone | (951) 674-9243 |
| Mailing Fax Number | 9516749635 |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2085 Rustin Ave, Riverside, CA 925072498 | 9519557263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598745911 | Mark Alfred Desjardins | Family Medicine | Naval Ambulatory Care Center, Route 12 Bldg 449 Attn Professional Affairs, Groton, CT 06349-5600 | 2006-01-20 |
| Street Address |
265 SAN JACINTO RIVER RD STE 107 |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530-4400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265799654 | Gemma Rachel Fields | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2012-04-23 |
| 1699380204 | Willis Dean Torres Jr. | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2020-09-10 |
| 1083253918 | Suzen Pando | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2019-12-23 |
| 1619520145 | Patricia N Rivera Robles | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2019-07-23 |
| 1821650722 | Magaly Macias | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2019-07-01 |
| 1710456769 | Sergio A Castaneda Munguia | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2018-11-20 |
| 1225513187 | Melissa Martina Rodriguez | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2018-09-26 |
| 1598256893 | Stephanie A Ackroyd | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2018-05-22 |
| 1154827434 | Gema Nava Celis | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2018-04-04 |
| 1225534746 | Valerie Eichelberg | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2018-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1861771677 | Judy Kelly | Marriage & Family Therapist | 224 West Graham Ave, Lake Elsinore, CA 92530 | 2011-08-10 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| Find all providers in zip 92530 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114552759 | Jennifer J Wren | Counselor | 31764 Casino Dr # 200300, Lake Elsinore, CA 92530-2312 | 2020-03-04 |
| 1538711049 | Nakisha Lavon Grant | Counselor | 31772 Casino Dr Ste A&b, Lake Elsinore, CA 92530-4502 | 2019-07-15 |
| 1952809477 | Marissa Moreno | Counselor | 600 Central Ave Ste 1, Lake Elsinore, CA 92530-2740 | 2018-01-30 |
| 1558806166 | Khumbuzile Dlamini | Counselor | 53091 Memorial St, Lake Elsinore, CA 92532-1569 | 2017-01-05 |
| 1942661673 | Karen Joya | Counselor | 600 Central Ave # E1, Lake Elsinore, CA 92530-2740 | 2016-03-08 |
| 1588906952 | Natalia Kearney Isaacs | Counselor | 600 Central Ave Ste E1, Lake Elsinore, CA 92530-2749 | 2013-03-22 |
| 1336486893 | Rachel Nicole Mobley | Counselor | 265 San Jacinto River Road, Suite 107, Lake Elsinore, CA 92530-4400 | 2013-01-03 |
| 1265799654 | Gemma Rachel Fields | Counselor | 265 San Jacinto River Rd Ste 107, Lake Elsinore, CA 92530-4400 | 2012-04-23 |
| 1326202243 | Anna Marie Vaughn | Counselor | 31946 Mission Trail Ste B, Lake Elsinore, CA 92530 | 2008-07-10 |
| 1659544708 | Susan Marie Kell | Counselor | 30713 Riverside Dr, Suite 203, Lake Elsinore, CA 92530-4714 | 2008-04-09 |
| Find all providers in LAKE ELSINORE | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
Please comment or provide details below to improve the information on MR. MARK PETER DESJARDINS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.