| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DE'RON HACKLER | 1225612922 | 2023-10-13 |
De'ron Hackler is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225612922. Registration indicates De'ron Hackler is a provider of services with a specialization in Other Service Providers, Case Manager/Care Coordinator (Case Manager/Care Coordinator, ) (All Other Specialties & Provider Types, ) (Case Manager/Care Coordinator, Other Service Providers)
| Entity Type | Individual |
| Provider Name | De'ron Hackler |
| Practice Office Address | 892 27TH ST SAN DIEGO, CA US |
| Practice Office Telephone | 6195754687 |
| Mailing Address | 892 27TH ST SAN DIEGO, CA 921541444 US |
| Code | Practice | License No State |
|---|---|---|
| 171M00000X PRIMARY | Other Service Providers Case Manager/Care Coordinator Case Manager/Care Coordinator All Other Specialties & Provider Types Case Manager/Care Coordinator Other Service Providers |