Individual
DAKOTAH EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA ENGLISH
Contact information
Practice address
7273 14TH AVE, SACRAMENTO, CA 95820-3575
(916) 316-2464
Mailing address
2411 CLEAT LN UNIT 301, SACRAMENTO, CA 95818-2882
(916) 316-2464
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
04/23/2025
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