Provider Demographics
NPI:1295379519
Name:HAVRANEK, SAVANNAH JEAN
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:JEAN
Last Name:HAVRANEK
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 1:904 G ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1829
Mailing Address - Country:US
Mailing Address - Phone:707-269-2001
Mailing Address - Fax:
Practice Address - Street 1:537 9TH ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1861
Practice Address - Country:US
Practice Address - Phone:707-269-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator