Provider Demographics
NPI:1689798241
Name:CONTRERAS, ANTONIO JR
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:CONTRERAS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-3876
Mailing Address - Country:US
Mailing Address - Phone:916-484-1967
Mailing Address - Fax:
Practice Address - Street 1:1150 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-5308
Practice Address - Country:US
Practice Address - Phone:916-609-4261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor