Provider Demographics
NPI:1114548393
Name:CLOYES, DAVID M (CADC-CAS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:CLOYES
Suffix:
Gender:M
Credentials:CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8190 STARLITE PINES RD
Mailing Address - Street 2:
Mailing Address - City:SHINGLETOWN
Mailing Address - State:CA
Mailing Address - Zip Code:96088-9551
Mailing Address - Country:US
Mailing Address - Phone:858-752-7107
Mailing Address - Fax:
Practice Address - Street 1:3590 EL PORTAL DR APT 15
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-3154
Practice Address - Country:US
Practice Address - Phone:530-722-1114
Practice Address - Fax:530-722-1115
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC0040081116OtherCCAPP