Healthcare Provider Details
I. General information
NPI: 1225927635
Provider Name (Legal Business Name): SEASONS PSYCHOLOGY SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3175 SUNSET BLVD STE 104A2
ROCKLIN CA
95677-3091
US
IV. Provider business mailing address
3175 SUNSET BLVD STE 104A2
ROCKLIN CA
95677-3091
US
V. Phone/Fax
- Phone: 916-625-6265
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REBECCA
LIERLY
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 408-702-5253