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Gerrod Herndon, SUDRC#15464
Substance Use Disorder Rehabilitation Clinic/Center in San Rafael, California
NPI 1689368615

Gerrod Herndon is a Substance Use Disorder Rehabilitation Clinic/Center based in San Rafael, CA and is specialized in Rehabilitation, Substance Use Disorder. Gerrod Herndon practices in San Rafael, CA and has the professional credentials of SUDRC#15464. The NPI Number for Gerrod Herndon is 1689368615 and holds a License No. 15464 (California).

The current practice location address for Gerrod Herndon is 603 D St, San Rafael, CA and can be reached out via phone at 707-331-5575.

Location: 603 D St, San Rafael, CA, 94901-3719
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689368615
Provider Name
Gerrod Herndon
Credential
SUDRC#15464
Provider Entity Type
Individual
Gender
Male
Address
603 D St, San Rafael, CA, 94901-3719
Phone Number
707-331-5575
Fax Number
Provider Enumeration Date
06/05/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
603 D St
City
San Rafael
State
California
Zip
94901-3719
Phone Number
707-331-5575
Fax Number
person
Provider Business Mailing Address Details
Address
603 D St
City
San Rafael
State
California
Zip
94901-3719
Phone Number
707-331-5575
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
15464 (California)
Definition
Definition to come...
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