Individual
CARI RENEE MCCRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC - CAS
Contact information
Practice address
2844 COLOMA ST, PLACERVILLE, CA 95667-4406
(530) 626-9240
(530) 626-8992
Mailing address
PO BOX 586, CAMINO, CA 95709-0586
(530) 626-9240
(530) 644-3782
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C057370618
CA
174400000X
Specialist
03107172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03107172
CERTIFIED ALCOHOL AND DRUG SPECIALIST
CA
Enumeration date
03/17/2011
Last updated
10/23/2019
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