Healthcare Provider Details

I. General information

NPI: 1740862739
Provider Name (Legal Business Name): KAITLYN CHRISTINE GIOIA SINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 04/28/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 C ST STE 3
DAVIS CA
95616-4588
US

IV. Provider business mailing address

6 STRIDE CT
SACRAMENTO CA
95817-2420
US

V. Phone/Fax

Practice location:
  • Phone: 916-436-1744
  • Fax:
Mailing address:
  • Phone: 916-457-7085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4605
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number105837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: