Healthcare Provider Details

I. General information

NPI: 1811842180
Provider Name (Legal Business Name): WILLOW BRANCH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 SUNRISE BLVD STE 104
FAIR OAKS CA
95628-4940
US

IV. Provider business mailing address

867 J ST
LINCOLN CA
95648-1756
US

V. Phone/Fax

Practice location:
  • Phone: 916-495-5910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: NADEZHDA TYUTYUNIK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-420-4166