DEREK BOURDESS


Address: 24460 Lyons Ave, Santa Clarita, CA 91321-2347
Phone: 6612539400

DEREK BOURDESS (NPI# 1760959597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760959597
Entity Type Individual
Full Name DEREK BOURDESS
Practice Address 24460 Lyons Ave
Santa Clarita
CA 91321-2347
Mailing Address 6802 Jellico Ave
Van Nuys
CA 91406-4334
Practice Telephone 6612539400
Mailing Telephone 7472424114
Enumeration Date 2018-10-30
Last Update Date 2018-10-30
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 24460 LYONS AVE
City SANTA CLARITA
State CA
Zip Code 91321-2347

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851645006 National Council On Alcoholism & Drug Dependence of The San Fernando V Community/Behavioral Health 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2012-11-08
1639647910 Megan Brooke Stewart Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2018-11-05
1699269662 Oscar Alvarez Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2018-06-21
1619489382 Jodi Sharp Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2017-11-02
1164963575 Matthew Jay Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2017-03-17
1659766962 Brenda Tumasone Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2015-04-02
1194119800 Kenneth Settle Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2015-03-20
1215329479 Damian Costa Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2015-02-25
1023411774 Barry Olson Olson Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2014-10-08
1801202320 James Lochridge Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2014-07-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1275157265 Lauren Tolcher Behavioral Analyst 23502 Lyons Avenue, Suite 304a, Santa Clarita, CA 91321 2020-06-04
1427613900 Weston William Lensing Behavior Technician 3502 Lyons Ave, Ste 304a, Santa Clarita, CA 91321 2019-05-09
1174005003 Eparthenos Psychologist 23504 Lyons Ave #304, Santa Clarita, CA 91321 2018-09-06
1740761105 The Center for Creative Therapy, Inc Marriage & Family Therapist 23030 Lyons Ave Ste 207, Santa Clarita, CA 91321 2018-08-23
1982196879 Brandi Wright-dohopolski Acupuncturist 27820 Freemont Court, Unit 5, Suite E, Valencia, CA 91321 2018-06-06
1780113209 Jennifer Ann Woods Physician Assistant 23645 Meadowridge Drive, 110, Newhall, CA 91321 2017-06-08
1942661624 Sina Tebi Md Inc Internal Medicine 23938 Lyons Avenue, #204, Newhall, CA 91321 2016-03-09
1720452220 Julie Kim Pharmacist 26863 Sierra Hwy, Santa Clarita, CA 91321 2015-11-20
1568855773 Carly Nikiforuk Counselor 24625 Arch St., Newhall, CA 91321 2015-03-12
1437562741 Teresa Cha Waggoner Nurse Practitioner 23772 Newhall Avenue, Newhall, CA 91321 2014-06-04
Find all providers in zip 91321

Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720550874 Jessica Lara Counselor 22519 Garzota Dr, Santa Clarita, CA 91350-2247 2018-12-28
1548680523 Gwendolyn Macdonald Counselor 26708 Oak Pluma Ct, Santa Clarita, CA 91321-1441 2014-04-17
1134323645 Mayra Arambula Counselor 21754 Fritz Way, Santa Clarita, CA 91390-5717 2007-06-11
1568925931 Cyrush Akbar Counselor 21545 Centre Pointe Pkwy, Santa Clarita, CA 91350-2947 2019-04-11
1780145029 Amanda Ellis Counselor 21545 Centre Pointe Pkwy, Santa Clarita, CA 91350-2947 2019-03-28
1639647910 Megan Brooke Stewart Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2018-11-05
1699269662 Oscar Alvarez Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2018-06-21
1619489382 Jodi Sharp Counselor 24460 Lyons Ave, Santa Clarita, CA 91321-2347 2017-11-02
1235662990 Joshua Davis Counselor 38215 San Francisquito Canyon Rd, Santa Clarita, CA 91390-4914 2017-04-09
1366973562 Sofia Vargas Counselor 26460 Summit Cir, Santa Clarita, CA 91350-2991 2017-03-21
Find all providers in SANTA CLARITA

Competitor

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City SANTA CLARITA
Zip Code 91321

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Dataset Information

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.

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