Provider Demographics
NPI:1629029962
Name:STARATEIES FOR CHANGE
Entity Type:Organization
Organization Name:STARATEIES FOR CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:RRW, AACD
Authorized Official - Phone:916-448-2951
Mailing Address - Street 1:4409 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-3701
Mailing Address - Country:US
Mailing Address - Phone:916-455-8293
Mailing Address - Fax:
Practice Address - Street 1:1507 21ST ST
Practice Address - Street 2:100
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty