Most Relevant Information
Provider Data
| NPI Number: | 1003678822 |
| Provider Name: | RODNEY WAYNE BLACK |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/26/2024 |
| Last Updated: | 01/26/2024 |
Provider Practice Location
6300 EHRHARDT AVE
SACRAMENTO
CA
958235637
Practice Location Phone/Fax
| Phone: | 9167183626 |
| Fax: |
Provider Mailing Location
6300 EHRHARDT AVE
SACRAMENTO
CA
958235637
Provider Mailing Phone/Fax
| Phone: | 9167183626 |
| Fax: |