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Deandre Dickerson
Peer Specialist in Gardena, California
NPI 1013641059

Deandre Dickerson is a Peer Specialist based in Gardena, CA. Deandre Dickerson practices in Gardena, CA. The NPI Number for Deandre Dickerson is 1013641059 and holds a License No. (California).

The current practice location address for Deandre Dickerson is 15519 Crenshaw Blvd, Gardena, CA and can be reached out via phone at 310-679-2730.

Location: 15519 Crenshaw Blvd, Gardena, CA, 90249-4525
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013641059
Provider Name
Deandre Dickerson
Credential
Provider Entity Type
Individual
Gender
Male
Address
15519 Crenshaw Blvd, Gardena, CA, 90249-4525
Phone Number
310-679-2730
Fax Number
Provider Enumeration Date
07/14/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
15519 Crenshaw Blvd
City
Gardena
State
California
Zip
90249-4525
Phone Number
310-679-2730
Fax Number
person
Provider Business Mailing Address Details
Address
15519 Crenshaw Blvd
City
Gardena
State
California
Zip
90249-4525
Phone Number
310-679-2730
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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