Keith Hardrick Vielle, SUDCC 6465
Counselor, Addiction (Substance Use Disorder) in Cerritos, CA. Individual provider (NPI-1).
NPI number1114101763
StatusActive
Last updated in NPPESMay 20, 2025
Details
- NPI
- 1114101763
- Entity type
- Individual (NPI-1)
- Name
- Mr. Keith Hardrick Vielle
- Credential
- SUDCC 6465
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 18, 2007
- Certification date
- May 20, 2025
- Last updated
- May 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 104185 | CA | Yes |
| 172V00000X | Community Health Worker | – | – | |
| 373H00000X | Day Training/Habilitation Specialist | – | – |
Practice location
17707 Studebaker RdCerritos, CA 90703-2640
Phone 562-402-0677
Mailing address
17707 Studebaker RdCerritos, CA 90703-2640
Phone 562-402-0677
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Other Addiction (Substance Use Disorder) Counselor providers in Cerritos, CA
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- Maria DavalosNPI 1194944041
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- James Lamar YoungNPI 1366760886
All 7 Addiction (Substance Use Disorder) Counselor providers in Cerritos · All 2,293 providers in Cerritos
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