Mr Dmitriy Victor Puchkarev, ASW is a
Counselor - Addiction (substance Use Disorder) based in Venice, California. Mr Dmitriy Victor Puchkarev is licensed to practice in California (license number ) and his current practice location is
503 Ocean Front Walk, Venice, California. He can be reached at his office (for appointments etc.) via phone at
(310) 392-3070.
NPI number for Mr Dmitriy Victor Puchkarev is 1215537121 and his current mailing address is 10943 National Blvd Apt 6, Los Angeles, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1215537121.
Healthcare Provider's Profile
| Full Name | Mr Dmitriy Victor Puchkarev |
|---|
| Gender | Male |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 503 Ocean Front Walk, Venice, 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: 1215537121
- Provider Enumeration Date: 10/29/2020
- Last Update Date: 04/18/2025
Medical Identifiers
Medical identifiers for Mr Dmitriy Victor Puchkarev such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215537121 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 127235 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (California) | 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. Mr Dmitriy Victor Puchkarev 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 |
|---|
Mr Dmitriy Victor Puchkarev, ASW
10943 National Blvd Apt 6,
Los Angeles, CA 90064-4052
Ph: (858) 213-9391 | Mr Dmitriy Victor Puchkarev, ASW
503 Ocean Front Walk,
Venice, CA 90291-2403
Ph: (310) 392-3070 |
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