Provider Demographics
NPI:1255001616
Name:VOLONTIR, SVETALANA
Entity Type:Individual
Prefix:
First Name:SVETALANA
Middle Name:
Last Name:VOLONTIR
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 1:7509 MADISON AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7464
Mailing Address - Country:US
Mailing Address - Phone:916-314-7172
Mailing Address - Fax:
Practice Address - Street 1:7509 MADISON AVE STE 114
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7464
Practice Address - Country:US
Practice Address - Phone:916-314-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86669225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist