Healthcare Provider Details

I. General information

NPI: 1477337558
Provider Name (Legal Business Name): JAMIE WILLIAM BARRETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LEAD HILL BLVD STE 160
ROSEVILLE CA
95661-2998
US

IV. Provider business mailing address

1860 SIERRA GARDENS DR UNIT 143
ROSEVILLE CA
95661-1006
US

V. Phone/Fax

Practice location:
  • Phone: 916-740-6424
  • Fax:
Mailing address:
  • Phone: 916-546-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number18608
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: