Healthcare Provider Details

I. General information

NPI: 1831395532
Provider Name (Legal Business Name): CONNIE RENEE RHODES BS, CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONNIE RENEE FRENCH

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1789 W YOSEMITE AVE
MANTECA CA
95337-5130
US

IV. Provider business mailing address

4330 AUBURN BLVD STE 2200
SACRAMENTO CA
95841-4107
US

V. Phone/Fax

Practice location:
  • Phone: 209-825-3700
  • Fax:
Mailing address:
  • Phone: 916-473-5764
  • Fax: 916-473-5766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number82017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: