Provider Demographics
NPI:1336839133
Name:CONTRERAS, MICHAELA (CPT)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 MADISON AVE # A91
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-5600
Mailing Address - Country:US
Mailing Address - Phone:916-626-7777
Mailing Address - Fax:
Practice Address - Street 1:5015 MADISON AVE # A91
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-5600
Practice Address - Country:US
Practice Address - Phone:916-626-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT02163512246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy