Provider Demographics
NPI:1972174274
Name:RENE NEVAREZ LICENSED FAMILY THERAPIST AND CLINICAL COUNSELOR
Entity Type:Organization
Organization Name:RENE NEVAREZ LICENSED FAMILY THERAPIST AND CLINICAL COUNSELOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-784-4593
Mailing Address - Street 1:8950 CAL CENTER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3247
Mailing Address - Country:US
Mailing Address - Phone:916-784-4593
Mailing Address - Fax:
Practice Address - Street 1:8950 CAL CENTER DR STE 120
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3247
Practice Address - Country:US
Practice Address - Phone:916-738-1504
Practice Address - Fax:916-200-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty