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NPI Code Detail

MEDICARE: KAREN SNOW RADT

MEDICARE: KAREN SNOW RADT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorR1236680816CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R1236680816OTHERCARADT

General Provider Information

NPI Number : 1053836312
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN SNOW RADT
Provider Business Mailing Address
First Line : 1001 GRAND AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-3512
Country : US
Telephone Number : 916-929-1951
Fax Number : 916-929-5116
Provider Business Practice Location Address
First Line : 1001 GRAND AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-3512
Country : US
Telephone Number : 916-929-1951
Fax Number : 916-929-5116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2017
Last Update Date : 08/08/2017

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