Individual
RANDY ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 HOWE AVE, SACRAMENTO, CA 95825-4669
(916) 376-7736
Mailing address
3815 MARCONI AVE, SACRAMENTO, CA 95821-3867
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ICZJTE
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
01/11/2021
Last updated
03/05/2024
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