Healthcare Provider Details

I. General information

NPI: 1396625448
Provider Name (Legal Business Name): AUDREY VRABLIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 MARCONI AVE
SACRAMENTO CA
95821-5264
US

IV. Provider business mailing address

2845 MARCONI AVE
SACRAMENTO CA
95821-5264
US

V. Phone/Fax

Practice location:
  • Phone: 916-580-1103
  • Fax:
Mailing address:
  • Phone: 916-580-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: