Healthcare Provider Details

I. General information

NPI: 1205758828
Provider Name (Legal Business Name): SOUL JOURNEY PSYCHOTHERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
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: 916-761-5492
  • Fax:
Mailing address:
  • Phone: 916-761-5492
  • 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: HEATHER NORTON MOSS
Title or Position: CLINICAL DIRECTOR
Credential: LMFT
Phone: 916-761-5492