Provider Demographics
NPI:1194853630
Name:HARRIS, DRANELLA TANISHA
Entity Type:Individual
Prefix:MRS
First Name:DRANELLA
Middle Name:TANISHA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7865 SUNRISE MIST WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-5328
Mailing Address - Country:US
Mailing Address - Phone:916-256-8880
Mailing Address - Fax:
Practice Address - Street 1:3353 BRADSHAW RD STE 103
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2608
Practice Address - Country:US
Practice Address - Phone:916-857-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator