Provider Demographics
NPI:1326176843
Name:HANNAH, VANETTA LEROYCE
Entity Type:Individual
Prefix:
First Name:VANETTA
Middle Name:LEROYCE
Last Name:HANNAH
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 1:6789 RANCHO ADOBE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-1920
Mailing Address - Country:US
Mailing Address - Phone:916-607-3337
Mailing Address - Fax:
Practice Address - Street 1:3353 BRADSHAW RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2607
Practice Address - Country:US
Practice Address - Phone:916-857-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor