Healthcare Provider Details

I. General information

NPI: 1184539918
Provider Name (Legal Business Name): COLTON DANIEL PARSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 PARK TERRACE DR
GALT CA
95632-3766
US

IV. Provider business mailing address

2350 AMERICAN RIVER DR APT 305
SACRAMENTO CA
95825-7030
US

V. Phone/Fax

Practice location:
  • Phone: 209-745-5462
  • Fax:
Mailing address:
  • Phone: 916-488-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number260155674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: