Healthcare Provider Details
I. General information
NPI: 1639600851
Provider Name (Legal Business Name): JEFFREY ALAN KUKRAL LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/21/2017
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8035 MADISON AVE STE A4
CITRUS HEIGHTS CA
95610-7949
US
IV. Provider business mailing address
901 H ST STE 120
SACRAMENTO CA
95814-1817
US
V. Phone/Fax
- Phone: 916-524-6064
- Fax:
- Phone: 916-524-6064
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: