Individual
KYM RYNEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4049 MILLER WAY, SACRAMENTO, CA 95817-1332
(916) 451-9312
(916) 451-4018
Mailing address
4049 MILLER WAY, SACRAMENTO, CA 95817-1332
(916) 451-9312
(916) 451-4018
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
94-1582683
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R117281214
AOD COUNSELOR
CA
Enumeration date
03/02/2015
Last updated
03/02/2015
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