Provider Demographics
NPI:1508997370
Name:MOTSCHMAN, VERNON ARNOLD (CADCII)
Entity Type:Individual
Prefix:MR
First Name:VERNON
Middle Name:ARNOLD
Last Name:MOTSCHMAN
Suffix:
Gender:M
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 DONNA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-5517
Mailing Address - Country:US
Mailing Address - Phone:951-487-9627
Mailing Address - Fax:951-487-2448
Practice Address - Street 1:607 DONNA WAY
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-5517
Practice Address - Country:US
Practice Address - Phone:951-487-9627
Practice Address - Fax:951-487-2448
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARA837901101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)