Most Relevant Information
Provider Data
| NPI Number: | 1003520826 |
| Provider Name: | KAI MARTIN DENIS CADC 1 |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/06/2023 |
| Last Updated: | 01/06/2023 |
Provider Practice Location
2403 PROFESSIONAL DR
SANTA ROSA
CA
954033007
Practice Location Phone/Fax
| Phone: | 7075443295 |
| Fax: |
Provider Mailing Location
2403 PROFESSIONAL DR
SANTA ROSA
CA
954033007
Provider Mailing Phone/Fax
| Phone: | 7075443295 |
| Fax: |