Provider Demographics
NPI:1528369022
Name:SAAVEDRA, MARVIN ENRIQUE (CAADE)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:ENRIQUE
Last Name:SAAVEDRA
Suffix:
Gender:M
Credentials:CAADE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 EL CAMINO REAL # 313B
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-4446
Mailing Address - Country:US
Mailing Address - Phone:415-292-3420
Mailing Address - Fax:415-292-3404
Practice Address - Street 1:636 EL CAMINO REAL # 313B
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-4446
Practice Address - Country:US
Practice Address - Phone:415-292-3420
Practice Address - Fax:415-292-3404
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker