Provider Demographics
NPI:1376203109
Name:ANDERSON, HARLEIGH RAE
Entity Type:Individual
Prefix:
First Name:HARLEIGH
Middle Name:RAE
Last Name:ANDERSON
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 1:3840 ROSIN CT STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1645
Mailing Address - Country:US
Mailing Address - Phone:916-833-3275
Mailing Address - Fax:
Practice Address - Street 1:3840 ROSIN CT STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1645
Practice Address - Country:US
Practice Address - Phone:916-883-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker