Provider Demographics
NPI:1720520596
Name:HORSTMAN, DAVID (CADC-CAS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HORSTMAN
Suffix:
Gender:M
Credentials:CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22405 ADOBE RD
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-9395
Mailing Address - Country:US
Mailing Address - Phone:480-370-1235
Mailing Address - Fax:
Practice Address - Street 1:2110 FERRY ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3459
Practice Address - Country:US
Practice Address - Phone:530-365-8523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC03961116101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC039681116OtherCCAPP CREDENTIAL #