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NPI Code Detail

MEDICARE: MISS KATHERINE SHIELDS CAMPBELL MFT

MEDICARE: MISS KATHERINE SHIELDS CAMPBELL MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist40932CA

General Provider Information

NPI Number : 1538275839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KATHERINE SHIELDS CAMPBELL MFT
Provider Business Mailing Address
First Line : 3160 BAKULA WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95864-2625
Country : US
Telephone Number : 916-484-1374
Fax Number :
Provider Business Practice Location Address
First Line : 8233 E STOCKTON BLVD STE D
Second Line :
City : SACRAMENTO
State : CA
Zip : 95828-8203
Country : US
Telephone Number : 916-236-4751
Fax Number : 916-405-6551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 12/21/2010

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Directions to “ MISS KATHERINE SHIELDS CAMPBELL MFT” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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