MEDICARE: AGNE SLUCKAITE

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
1	106H00000X	Marriage & Family Therapist	46351	CA
2	106H00000X	Marriage & Family Therapist		CA

General Provider Information

NPI Number	:	1861539017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGNE SLUCKAITE

Provider Business Mailing Address
First Line	:	409 IRON HILL ST
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-5600
Country	:	US
Telephone Number	:	925-408-4076
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 BUSINESS CENTER DR STE 210
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-1696
Country	:	US
Telephone Number	:	925-408-4076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	03/04/2024

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Directions to “ AGNE SLUCKAITE ” Practice Location

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