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5325 Engle Rd Suite 200 Carmichael CA 95608-3091 | |
| (916) 421-1184 | |
| (916) 421-1188 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 5325 Engle Rd, Carmichael, California |
| Authorized Official Name and Position | Linda S Johnson (PROGRAM ADMINSITRATOR) |
| Authorized Official Contact | 9164211184 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3811 Florin Rd Suite 26 Sacramento CA 95823-1800 Ph: (916) 421-1184 | 5325 Engle Rd Suite 200 Carmichael CA 95608-3091 Ph: (916) 421-1184 |
| NPI Number | 1982931358 |
|---|---|
| Provider Enumeration Date | 11/05/2009 |
| Last Update Date | 12/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982931358 | NPI | - | NPPES |
| 343471 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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