Individual
KENNETH DEAN SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC CAS
Contact information
Practice address
3107 E KAWEAH AVE, VISALIA, CA 93292-3309
(559) 754-2705
(559) 754-2708
Mailing address
3107 E KAWEAH AVE, VISALIA, CA 93292-3309
(559) 754-2705
(559) 754-2708
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
C29611214
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C29611214
CCAPP
CA
Enumeration date
01/11/2017
Last updated
01/11/2017
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