Healthcare Provider Details

I. General information

NPI: 1821716671
Provider Name (Legal Business Name): APRIL VATERS CADC-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10089 FOLSOM BLVD STE A
RANCHO CORDOVA CA
95670-1935
US

IV. Provider business mailing address

4661 ORANGE GROVE AVE APT 24
SACRAMENTO CA
95841-4260
US

V. Phone/Fax

Practice location:
  • Phone: 916-366-6531
  • Fax: 916-366-6532
Mailing address:
  • Phone: 916-676-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCI39070623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: