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NPI Code Detail

MEDICARE: RAKIVA BROWN WARRENS CADC-CAS

MEDICARE: RAKIVA BROWN WARRENS CADC-CAS
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) CounselorC040950217CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C040950217OTHERCACADC-CAS

General Provider Information

NPI Number : 1578089090
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAKIVA BROWN WARRENS CADC-CAS
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 :
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 :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2017
Last Update Date : 07/21/2022

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