Alex John Deturck, is a
Community Health Worker based in San Luis Obispo, California. Alex John Deturck is licensed to practice in * (Not Available) (license number ) and his current practice location is
1255 Kendall Rd, San Luis Obispo, California. He can be reached at his office (for appointments etc.) via phone at
(805) 781-3535.
NPI number for Alex John Deturck is 1952061152 and his current mailing address is 1117 Vista Del Lago, San Luis Obispo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1952061152.
Healthcare Provider's Profile
| Full Name | Alex John Deturck |
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| Gender | Male |
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| Speciality | Community Health Worker |
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| Location | 1255 Kendall Rd, San Luis Obispo, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1952061152
- Provider Enumeration Date: 12/29/2021
- Last Update Date: 04/20/2023
Medical Identifiers
Medical identifiers for Alex John Deturck such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1952061152 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alex John Deturck is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Alex John Deturck,
1117 Vista Del Lago,
San Luis Obispo, CA 93405-4832
Ph: (650) 474-1266 | Alex John Deturck,
1255 Kendall Rd,
San Luis Obispo, CA 93401-8750
Ph: (805) 781-3535 |
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