Healthcare Provider Details

I. General information

NPI: 1740574672
Provider Name (Legal Business Name): BEATRICE ELIZABETH MCCALL-SALERNO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 ELK GROVE FLORIN RD 330
ELK GROVE CA
95624-9532
US

IV. Provider business mailing address

8575 ELK GROVE FLORIN RD 330
ELK GROVE CA
95624-9532
US

V. Phone/Fax

Practice location:
  • Phone: 916-833-9558
  • Fax:
Mailing address:
  • Phone: 916-833-9558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC42444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: