person
Tiffany A Revilla, SUDCOUNSELOR
Addiction (Substance Use Disorder) Counselor in Santa Rosa, California
NPI 1124613674

Tiffany A Revilla is an Addiction (Substance Use Disorder) Counselor based in Santa Rosa, CA and is specialized in Addiction (Substance Use Disorder). Tiffany A Revilla practices in Santa Rosa, CA and has the professional credentials of SUDCOUNSELOR. The NPI Number for Tiffany A Revilla is 1124613674 and holds a License No. 11616 (California).

The current practice location address for Tiffany A Revilla is 3555 Sonoma Hwy, Santa Rosa, CA and can be reached out via phone at 707-526-3150 and via fax at 707-581-2155.

Location: 3555 Sonoma Hwy, Santa Rosa, CA, 95409-4024
person
Provider Profile Details
NPI Number
1124613674
Provider Name
Tiffany A Revilla
Credential
SUDCOUNSELOR
Provider Entity Type
Individual
Gender
Female
Address
3555 Sonoma Hwy, Santa Rosa, CA, 95409-4024
Phone Number
707-526-3150
Fax Number
707-581-2155
Provider Enumeration Date
03/06/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3555 Sonoma Hwy
City
State
Zip
95409-4024
Phone Number
707-526-3150
Fax Number
707-581-2155
person
Provider Business Mailing Address Details
Address
3555 Sonoma Hwy
City
State
Zip
95409-4024
Phone Number
707-526-3150
Fax Number
707-581-2155
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
11616 (California)
Definition
Definition to come...
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