Provider Demographics
NPI:1467258483
Name:CARNES, CHANTE LANIECE (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:CHANTE
Middle Name:LANIECE
Last Name:CARNES
Suffix:
Gender:
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 CREEKSIDE RIDGE DR STE 280
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-3504
Mailing Address - Country:US
Mailing Address - Phone:916-524-3975
Mailing Address - Fax:
Practice Address - Street 1:3468 DAVIDSON DR
Practice Address - Street 2:
Practice Address - City:ANTELOPE
Practice Address - State:CA
Practice Address - Zip Code:95843-2253
Practice Address - Country:US
Practice Address - Phone:916-524-3975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician