Provider Demographics
NPI:1295499275
Name:AERSOLON, DREJUL CESSAIR (ASW)
Entity type:Individual
Prefix:
First Name:DREJUL
Middle Name:CESSAIR
Last Name:AERSOLON
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W BEAMER ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2510
Mailing Address - Country:US
Mailing Address - Phone:530-405-2856
Mailing Address - Fax:
Practice Address - Street 1:215 W BEAMER ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2510
Practice Address - Country:US
Practice Address - Phone:530-405-2800
Practice Address - Fax:530-204-5255
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103999104100000X
CAASW103999104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty