Provider Demographics
NPI:1841545803
Name:KUHARSKI, THEODORE MITCHELL JR
Entity type:Individual
Prefix:MR
First Name:THEODORE
Middle Name:MITCHELL
Last Name:KUHARSKI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 J ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-3010
Mailing Address - Country:US
Mailing Address - Phone:916-550-5481
Mailing Address - Fax:916-822-8974
Practice Address - Street 1:1550 JULIESSE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-1803
Practice Address - Country:US
Practice Address - Phone:916-737-5555
Practice Address - Fax:916-473-5766
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA020861015101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)