Healthcare Provider Details

I. General information

NPI: 1215842315
Provider Name (Legal Business Name): NEXTLEVEL MARRIAGE FAMILY & CHILD COUNSELING THERAPY, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 PARSONS DR
FAIRFIELD CA
94533-7247
US

IV. Provider business mailing address

2010A HARBISON DR STE 437
VACAVILLE CA
95687-3900
US

V. Phone/Fax

Practice location:
  • Phone: 559-265-2332
  • Fax:
Mailing address:
  • Phone: 559-265-2332
  • 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: BRENDA JACKSON
Title or Position: DIRECTOR
Credential: LMFT
Phone: 559-265-2332