Provider Demographics
NPI:1407024425
Name:MOLINA, DAVID STEFAN (PHD, CATC-U, MRTC, P)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STEFAN
Last Name:MOLINA
Suffix:
Gender:M
Credentials:PHD, CATC-U, MRTC, P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000A, 1010C EMELINE AVE.
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1900
Mailing Address - Country:US
Mailing Address - Phone:831-425-0112
Mailing Address - Fax:831-425-1847
Practice Address - Street 1:1000A, 1010C EMELINE AVE.
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1900
Practice Address - Country:US
Practice Address - Phone:831-425-0112
Practice Address - Fax:831-425-1847
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)