Individual
MR. CHASEN MARK DREXEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RADT-1
Contact information
Practice address
9012 EL CAJON WAY APT 2, SACRAMENTO, CA 95826-3328
(916) 579-8167
Mailing address
1914 23RD ST, SACRAMENTO, CA 95816-7113
(916) 455-6258
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1482680922
CA
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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