Individual
MISS CATRIN TREVENA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RADT1
Contact information
Practice address
9370 MARLEMONT CIR, ELK GROVE, CA 95758-7605
(916) 691-3131
Mailing address
9370 MARLEMONT CIR, ELK GROVE, CA 95758-7605
(916) 531-9130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1193410215
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215287933
MEDICAL
CA
Enumeration date
05/05/2015
Last updated
05/05/2015
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