Healthcare Provider Details

I. General information

NPI: 1043175920
Provider Name (Legal Business Name): NEURORESILIENT PSYCHOTHERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 E BIDWELL ST STE 100
FOLSOM CA
95630-3561
US

IV. Provider business mailing address

2320 E BIDWELL ST STE 100
FOLSOM CA
95630-3561
US

V. Phone/Fax

Practice location:
  • Phone: 916-710-0503
  • Fax:
Mailing address:
  • Phone: 916-710-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER NAVA
Title or Position: PRESIDENT
Credential: LMFT
Phone: 916-710-0503