Provider Demographics
NPI:1982008272
Name:PREPARINGPEOPLEFORSUCCESS
Entity Type:Organization
Organization Name:PREPARINGPEOPLEFORSUCCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVEDIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-II
Authorized Official - Phone:916-575-8851
Mailing Address - Street 1:8780 MADISON AVE
Mailing Address - Street 2:224
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3950
Mailing Address - Country:US
Mailing Address - Phone:530-903-0799
Mailing Address - Fax:
Practice Address - Street 1:1513 SPORTS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1943
Practice Address - Country:US
Practice Address - Phone:916-575-8851
Practice Address - Fax:916-575-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGNB32012-03076251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health