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900 Fulton Ave Ste 270 Sacramento CA 95825-4516 | |
| (888) 511-4269 | |
| (888) 511-4258 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 900 Fulton Ave Ste 270, Sacramento, California |
| Authorized Official Name and Position | Jeffery Douglas Wilfong (PRESIDENT) |
| Authorized Official Contact | 8885114269 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 191381 Sacramento CA 95819-1381 Ph: (888) 511-4269 | 900 Fulton Ave Ste 270 Sacramento CA 95825-4516 Ph: (888) 511-4269 |
| NPI Number | 1972864320 |
|---|---|
| Provider Enumeration Date | 06/01/2012 |
| Last Update Date | 06/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972864320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFCC 46654 (California) | Primary |
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