Provider Demographics
NPI:1932220662
Name:CUMMINS, BILLY R (RAS ADMHS II)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:R
Last Name:CUMMINS
Suffix:
Gender:M
Credentials:RAS ADMHS II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N. COTTONWOOD ST. #20
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695
Mailing Address - Country:US
Mailing Address - Phone:530-666-8658
Mailing Address - Fax:530-666-8663
Practice Address - Street 1:120 N COTTONWOOD ST APT 20
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-6631
Practice Address - Country:US
Practice Address - Phone:530-666-8658
Practice Address - Fax:530-666-8663
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0504101804101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)