Ardis, Carolann

Ardis, Carolann is an individual health care provider with primary practice located at 1001 Broadway Suite 201, Jackson CA 95642. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Ardis, Carolann can be contacted via phone (209) 223-6412.

Contact Information

Primary practice address
1001 Broadway Suite 201 Jackson CA 95642
Phone: (209) 223-6412
Fax: (209) 223-0920
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X RASIRI-D0509150826 California

Profile Details

NPI number 1053532127
LBN Legal business name Ardis, Carolann
Credentials RAS
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053532127 NPPES
California Other RASIRI-D0509150826 ADDICTION SPECIALIST

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