| Material Source, Inc. | |
|
2380 E Bidwell St Folsom CA 95630-3455 | |
| (916) 207-4762 | |
| (916) 608-9284 |
| Full Name | Material Source, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2380 E Bidwell St, Folsom, California |
| Authorized Official Name and Position | Carol Titta (PRESIDENT) |
| Authorized Official Contact | 9162074762 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Material Source, Inc. 2380 E Bidwell St Folsom CA 95630-3455 Ph: (916) 207-4762 | Material Source, Inc. 2380 E Bidwell St Folsom CA 95630-3455 Ph: (916) 207-4762 |
| NPI Number | 1861253528 |
|---|---|
| Provider Enumeration Date | 01/19/2024 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861253528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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