Provider Demographics
NPI:1992171409
Name:DORADO, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:DORADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-1545
Mailing Address - Country:US
Mailing Address - Phone:661-871-3353
Mailing Address - Fax:661-871-9549
Practice Address - Street 1:3353 MT VERNON AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-1545
Practice Address - Country:US
Practice Address - Phone:661-871-3353
Practice Address - Fax:661-871-9549
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4006207101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)