Individual
DERRICK BANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
406 SUNRISE AVE STE 300, ROSEVILLE, CA 95661-4144
(916) 783-5207
Mailing address
3440 VIKING DR, SACRAMENTO, CA 95827-2844
(916) 591-4362
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
08/12/2015
Last updated
05/07/2025
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