Provider Demographics
NPI:1346322302
Name:GREENE, CHERYL A (CAADAC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:GREENE
Suffix:
Gender:F
Credentials:CAADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7691 RUSH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5578
Mailing Address - Country:US
Mailing Address - Phone:916-448-2951
Mailing Address - Fax:916-448-8949
Practice Address - Street 1:1507 21ST ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-5220
Practice Address - Country:US
Practice Address - Phone:916-448-2951
Practice Address - Fax:916-448-8949
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)