Provider Demographics
NPI:1306332762
Name:WNETRZAK, CHLOE (RBT)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:WNETRZAK
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 CATALPA LN
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6254
Mailing Address - Country:US
Mailing Address - Phone:951-905-4165
Mailing Address - Fax:
Practice Address - Street 1:215 CATALPA LN
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6254
Practice Address - Country:US
Practice Address - Phone:951-905-4165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician