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General NPI Number Information
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NPI Number | 1104057678
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Entity Type | Individual
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Provider Name | TERRANCE WOODROW RHOADES PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2009
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 1321 HOWE AVE STE 212
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City | SACRAMENTO
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State | CA
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Zip | 95825-3365
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Country | US
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Telephone | 916-990-7211
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Fax | 916-560-3575
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Provider Business Mailing Address
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Address Line | 6316 MONTEVERDE LN
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-4315
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Country | US
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Telephone | 916-560-3275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 22605
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License Number State | CA
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