Provider Demographics
NPI:1073025268
Name:PEARSON, WILLIAM CHARLES JR (CADC II/ICADC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:PEARSON
Suffix:JR
Gender:M
Credentials:CADC II/ICADC
Other - Prefix:
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Mailing Address - Street 1:925 LOUGHBOROUGH DR APT 227
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2316
Mailing Address - Country:US
Mailing Address - Phone:209-271-8257
Mailing Address - Fax:
Practice Address - Street 1:1471 B ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:CA
Practice Address - Zip Code:95334-1432
Practice Address - Country:US
Practice Address - Phone:209-381-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-29
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAA052141220101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)