Provider Demographics
NPI:1396456448
Name:HUNTER, JOHN E (CADC II)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:HUNTER
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9853 E AVENUE Q6
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93591-2210
Mailing Address - Country:US
Mailing Address - Phone:661-992-9398
Mailing Address - Fax:
Practice Address - Street 1:43322 GINGHAM AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4576
Practice Address - Country:US
Practice Address - Phone:661-874-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA049740518101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA049740518OtherCADC II