Healthcare Provider Details

I. General information

NPI: 1326296690
Provider Name (Legal Business Name): MS. KERRY L SCIACQUA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 TRANCAS ST
NAPA CA
94558-2905
US

IV. Provider business mailing address

208 SACRAMENTO ST
SUISUN CITY CA
94585-2447
US

V. Phone/Fax

Practice location:
  • Phone: 949-695-3114
  • Fax:
Mailing address:
  • Phone: 510-410-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: