Individual provider · NPI-1

Derrick Bane

Rehabilitation Practitioner · Roseville, CA

NPI number1972979003
StatusActive
Last updated in NPPESMay 7, 2025

Details

NPI
1972979003
Entity type
Individual (NPI-1)
Name
Derrick Bane
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 12, 2015
Certification date
May 7, 2025
Last updated
May 7, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225400000X Rehabilitation Practitioner––Yes
101Y00000X Counselor––
171M00000X Case Manager/Care Coordinator––
172V00000X Community Health Worker––
373H00000X Day Training/Habilitation Specialist––

Practice location

406 Sunrise Ave Ste 300
Roseville, CA 95661-4144

Phone 916-783-5207

Mailing address

3440 Viking Dr
Sacramento, CA 95827-2844

Phone 916-591-4362

Other practice locations

3810 Rosin Ct Ste 180
Sacramento, CA 95834-1656

Phone 916-283-8280

3440 Viking Dr Ste 114
Sacramento, CA 95827-2844

Phone 916-364-8395

7415 Henrietta Dr
Sacramento, CA 95822-5142

Phone 916-364-8395

505 M St
Rio Linda, CA 95673-2218

Phone 916-287-4067

2130 Stockton Blvd Bldg 300
Sacramento, CA 95817-1337

Phone 916-520-2460

7224 S Recovery Rd
French Camp, CA 95231

Phone 209-888-6595

7236 S Recovery Rd
French Camp, CA 95231

Phone 209-888-6595

406 Sunrise Ave Ste 300
Roseville, CA 95661-4144

Phone 916-783-5207

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Rehabilitation Practitioner providers in Roseville, CA