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2108 N St Ste N Sacramento CA 95816-5712 | |
| (509) 768-2249 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2108 N St Ste N, Sacramento, California |
| Authorized Official Name and Position | Jamal Devin Adams (CEO) |
| Authorized Official Contact | 4143506433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2108 N St Ste N Sacramento CA 95816-5712 Ph: () - | 2108 N St Ste N Sacramento CA 95816-5712 Ph: (509) 768-2249 |
| NPI Number | 1013750157 |
|---|---|
| Provider Enumeration Date | 06/17/2024 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013750157 | NPI | - | NPPES |
| 12278 | Other | CA | CALIFORNIA BOARD OF BEHAVIORAL SCIENCES |
| 8541-125 | Other | WI | WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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