Provider Demographics
NPI:1063930287
Name:ROLON, BIANCA YVETTE
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:YVETTE
Last Name:ROLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:ARBUCKLE
Mailing Address - State:CA
Mailing Address - Zip Code:95912-0472
Mailing Address - Country:US
Mailing Address - Phone:530-908-3299
Mailing Address - Fax:
Practice Address - Street 1:900 FULTON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4500
Practice Address - Country:US
Practice Address - Phone:916-484-3570
Practice Address - Fax:916-484-3577
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator