Provider Demographics
NPI:1609318096
Name:DELAO, ARTHUR ANTHONY
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:ANTHONY
Last Name:DELAO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ARTHUR
Other - Middle Name:ANTHONY
Other - Last Name:DELAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1133 COLOMA WAY STE C
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4480
Mailing Address - Country:US
Mailing Address - Phone:916-774-6647
Mailing Address - Fax:
Practice Address - Street 1:1133 COLOMA WAY STE C
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4480
Practice Address - Country:US
Practice Address - Phone:916-774-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)