Provider Demographics
NPI:1568749232
Name:GERALDS, SHALON KATINIA TEMARA (CADC I I)
Entity Type:Individual
Prefix:MRS
First Name:SHALON
Middle Name:KATINIA TEMARA
Last Name:GERALDS
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Gender:F
Credentials:CADC I I
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Mailing Address - Street 1:7240 E SOUTHGATE DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2627
Mailing Address - Country:US
Mailing Address - Phone:916-391-4293
Mailing Address - Fax:916-391-4247
Practice Address - Street 1:7240 E SOUTHGATE DR
Practice Address - Street 2:SUITE G
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2627
Practice Address - Country:US
Practice Address - Phone:916-391-4293
Practice Address - Fax:916-391-4247
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2015-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAI8316110101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)