| Sundance Life Enrichment, Inc. | |
|
3875 Taylor Rd Ste 204g Loomis CA 95650-9273 | |
| (530) 401-2078 | |
| Not Available |
| Full Name | Sundance Life Enrichment, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3875 Taylor Rd Ste 204g, Loomis, California |
| Authorized Official Name and Position | Shea Phinney Ridley (PRESIDENT) |
| Authorized Official Contact | 5304012078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sundance Life Enrichment, Inc. Po Box 1525 Loomis CA 95650-1525 Ph: () - | Sundance Life Enrichment, Inc. 3875 Taylor Rd Ste 204g Loomis CA 95650-9273 Ph: (530) 401-2078 |
| NPI Number | 1063807113 |
|---|---|
| Provider Enumeration Date | 04/04/2015 |
| Last Update Date | 04/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063807113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 50023 (California) | Primary |
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