Healthcare Provider Details

I. General information

NPI: 1144149139
Provider Name (Legal Business Name): SIX RIVERS WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 SAMOA BLVD STE 209
ARCATA CA
95521-6696
US

IV. Provider business mailing address

PO BOX 1254
WILLOW CREEK CA
95573-1254
US

V. Phone/Fax

Practice location:
  • Phone: 707-940-9528
  • Fax: 707-261-0541
Mailing address:
  • Phone: 707-940-9528
  • Fax: 707-261-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALEXA SHOCKLEY
Title or Position: AMFT
Credential:
Phone: 408-476-4493