Provider Demographics
NPI:1942348214
Name:MEHR, DAVID JOHN (CAS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOHN
Last Name:MEHR
Suffix:
Gender:M
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 CASA BUENA DR
Mailing Address - Street 2:303
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1765
Mailing Address - Country:US
Mailing Address - Phone:415-924-8751
Mailing Address - Fax:415-252-4790
Practice Address - Street 1:1441 CASA BUENA DR
Practice Address - Street 2:303
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1765
Practice Address - Country:US
Practice Address - Phone:415-924-8751
Practice Address - Fax:415-252-4790
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03-065653101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator