Provider Demographics
NPI:1861944100
Name:ARTEAGA, ROSALIO G
Entity type:Individual
Prefix:
First Name:ROSALIO
Middle Name:G
Last Name:ARTEAGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 SUNRISE BLVD APT 209
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-0449
Mailing Address - Country:US
Mailing Address - Phone:209-349-2202
Mailing Address - Fax:
Practice Address - Street 1:1050 FULTON AVE STE 235
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4299
Practice Address - Country:US
Practice Address - Phone:916-974-2599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst