Provider Demographics
NPI:1912347709
Name:DILLARD-AUSTIN, RANDEE ASHLEY
Entity Type:Individual
Prefix:
First Name:RANDEE
Middle Name:ASHLEY
Last Name:DILLARD-AUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9719 LINCOLN VILLAGE DR. #105
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827
Mailing Address - Country:US
Mailing Address - Phone:916-362-8292
Mailing Address - Fax:916-362-8295
Practice Address - Street 1:9719 LINCOLN VILLAGE DR STE 105
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3328
Practice Address - Country:US
Practice Address - Phone:916-362-8292
Practice Address - Fax:916-362-8295
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator