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874 57th St Sacramento CA 95819-3327 | |
| (916) 477-4494 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 874 57th St, Sacramento, California |
| Authorized Official Name and Position | Robert Austin Nganga (FOUNDER) |
| Authorized Official Contact | 9164774494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3705 Dayton St Sacramento CA 95838-3920 Ph: (916) 477-4494 | 874 57th St Sacramento CA 95819-3327 Ph: (916) 477-4494 |
| NPI Number | 1316647480 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Medicare PECOS PAC ID | 2961854518 |
|---|---|
| Medicare Enrollment ID | O20240221002853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316647480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Robert Nganga |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083150767 PECOS PAC ID: 3870945421 Enrollment ID: I20240221003105 |
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