Healthcare Provider Details

I. General information

NPI: 1861736126
Provider Name (Legal Business Name): JAMIE FRAZIER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: REBEKAH HOGAN/FRAZIER

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 MELODY LN STE 221
ROSEVILLE CA
95678-5207
US

IV. Provider business mailing address

1100 MELODY LN STE 221
ROSEVILLE CA
95678-5207
US

V. Phone/Fax

Practice location:
  • Phone: 916-300-4348
  • Fax:
Mailing address:
  • Phone: 916-300-4348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT92410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: