Provider Demographics
NPI:1801461140
Name:RAVIART, DANNY GEORGE (SUDCC)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:GEORGE
Last Name:RAVIART
Suffix:
Gender:M
Credentials:SUDCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3872 STATE HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6313
Mailing Address - Country:US
Mailing Address - Phone:530-295-7114
Mailing Address - Fax:
Practice Address - Street 1:3872 STATE HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6313
Practice Address - Country:US
Practice Address - Phone:530-295-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty