Provider Demographics
NPI:1265572630
Name:DINGLE, PIO B JR (CDAC-II)
Entity type:Individual
Prefix:
First Name:PIO
Middle Name:B
Last Name:DINGLE
Suffix:JR
Gender:M
Credentials:CDAC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41869 NAPOLI ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203
Mailing Address - Country:US
Mailing Address - Phone:760-485-0449
Mailing Address - Fax:
Practice Address - Street 1:44-199 MONROE ST.
Practice Address - Street 2:SUITE C
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201
Practice Address - Country:US
Practice Address - Phone:760-863-2857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAII58330518101YA0400X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator