Provider Demographics
NPI:1891707717
Name:TALLADINO, VICKI (LCSW)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:TALLADINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 AMETHYST WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-3329
Mailing Address - Country:US
Mailing Address - Phone:530-241-8616
Mailing Address - Fax:530-244-7547
Practice Address - Street 1:1740 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0435
Practice Address - Country:US
Practice Address - Phone:530-241-8616
Practice Address - Fax:530-244-7547
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS131861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical