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Individual

AUTUMN ROSE WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2750 SUTTERVILLE RD, SACRAMENTO, CA 95820-1093
(916) 787-7678
Mailing address
2750 SUTTERVILLE RD, SACRAMENTO, CA 95820-1093
(916) 425-3981

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
175T00000X
Peer Specialist
Primary
MPSS-KVXABI
CA

Other

Enumeration date
02/14/2024
Last updated
06/13/2024
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