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General NPI Number Information
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NPI Number | 1245767516
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Entity Type | Organization
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Legal Business Name | CHEMICAL DEPENDENCY TREATMENT ASSOCIATES, INC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 455 UNIVERSITY AVE STE 320
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City | SACRAMENTO
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State | CA
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Zip | 95825-6580
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Country | US
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Telephone | 916-333-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 455 UNIVERSITY AVE STE 320
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City | SACRAMENTO
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State | CA
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Zip | 95825-6580
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Country | US
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Telephone | 916-333-5955
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELLA BARR
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Credential | MD
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Telephone | 917-301-5917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 2012239
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License Number State | CA
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