Healthcare Provider Details

I. General information

NPI: 1285784561
Provider Name (Legal Business Name): SEE THAO CASELOAD MANAGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 ROSIN CT STE 170
SACRAMENTO CA
95834-1656
US

IV. Provider business mailing address

6834 ANCHOR CIR
FAIR OAKS CA
95628-3223
US

V. Phone/Fax

Practice location:
  • Phone: 916-567-4222
  • Fax:
Mailing address:
  • Phone: 916-774-6647
  • Fax: 916-774-6456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: