MR. DELANO HOMER SANDUSKY JR. (NPI# 1992032858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992032858 |
| Entity Type | Individual |
| Full Name | MR. DELANO HOMER SANDUSKY JR. |
| Practice Address |
3969 4th Ave Suite 203 San Diego CA 92103-3165 |
| Mailing Address |
3969 Fourth Ave. Suite 203 San Diego CA 92103 |
| Practice Telephone | 6195503420 |
| Mailing Telephone | 6195503420 |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2009-11-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
3969 4TH AVE SUITE 203 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-3165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972505139 | James Carey Fawcett | Urology | 3969 4th Ave, Suite 202, San Diego, CA 92103-3165 | 2005-06-01 |
| 1215297072 | Richard R Burns Md Inc | Specialist | 3969 4th Ave, Suite 300, San Diego, CA 92103-3165 | 2012-05-25 |
| 1972871382 | Kelly S Keefe Md Inc | Ophthalmology | 3969 4th Ave, Ste 301, San Diego, CA 92103-3165 | 2011-12-13 |
| 1831400811 | Suzanne P Handler Md Inc | Ophthalmology | 3969 4th Ave, Suite 301, San Diego, CA 92103-3165 | 2010-06-24 |
| 1821312190 | Courique Optical | Ophthalmology | 3969 4th Ave, Suite 301, San Diego, CA 92103-3165 | 2010-03-16 |
| 1003085572 | Barbara Denysiak | Legal Medicine | 3969 4th Ave, Ste. 203, San Diego, CA 92103-3165 | 2008-02-28 |
| 1861695975 | Scott William Irwin | Counselor | 3969 4th Ave, Suite 210, San Diego, CA 92103-3165 | 2007-06-06 |
| 1457562258 | Arthur J. Macwhinnie | Counselor | 3969 4th Ave, Suite 203, San Diego, CA 92103-3165 | 2007-05-24 |
| 1386852887 | David Allen Walls | Counselor | 3969 4th Ave, Suite 203, San Diego, CA 92103-3165 | 2007-05-18 |
| 1063638682 | Michael T Couris | Ophthalmology | 3969 4th Ave, Suite 301, San Diego, CA 92103-3165 | 2007-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1477166734 | Laura Aida Andrade | Counselor | 4125 Wabash Ave, San Diego, CA 92104-2124 | 2020-08-26 |
| 1679113096 | David Salvador Avalos | Counselor | 3642 Rosa Linda St, San Diego, CA 92154-3653 | 2020-01-14 |
| 1023651692 | Robert Joseph Kassel | Counselor | 6551 Seaman St, San Diego, CA 92120-2629 | 2019-10-25 |
| 1609437979 | Pamela Lynette Hill | Counselor | 3960 W Point Loma Blvd, San Diego, CA 92110-5643 | 2019-06-26 |
| 1154989838 | Victoria Philips | Counselor | 4055 58th St Apt 10, San Diego, CA 92115-6209 | 2019-05-29 |
| 1740847375 | Jessica Cristina Williams | Counselor | 1775 Elm Ave, San Diego, CA 92154-1104 | 2019-05-20 |
| 1659934164 | Virginia Denise Mcswain | Counselor | 220 Euclid Ave Ste 200, San Diego, CA 92114-3644 | 2019-04-19 |
| 1386107324 | Connie Padera | Counselor | 3148 Midway Dr # 113, San Diego, CA 92110-4539 | 2019-04-08 |
| 1154891067 | Vincent Garside | Counselor | 2516 A Sreet, San Diego, CA 92102-9210 | 2018-12-04 |
| Find all providers in SAN DIEGO | ||||
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| 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.