Provider Demographics
NPI:1598029787
Name:HUNTER, TIMOTHY RYAN
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RYAN
Last Name:HUNTER
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:PO BOX 8742
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-8742
Mailing Address - Country:US
Mailing Address - Phone:408-401-7600
Mailing Address - Fax:
Practice Address - Street 1:9343 TECH CENTER DR
Practice Address - Street 2:STE. 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2563
Practice Address - Country:US
Practice Address - Phone:916-388-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator