Provider Demographics
NPI:1760188700
Name:MEADE, JOHN BERNARD
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BERNARD
Last Name:MEADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 E AVENUE J4 APT G
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-6903
Mailing Address - Country:US
Mailing Address - Phone:661-576-9564
Mailing Address - Fax:
Practice Address - Street 1:1616 W AVENUE L
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-6247
Practice Address - Country:US
Practice Address - Phone:661-576-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)