Healthcare Provider Details

I. General information

NPI: 1891948691
Provider Name (Legal Business Name): MICHELLE RENEE ZUCKERMAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE RENEE BJARNARSON

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 EUREKA RD STE 102
ROSEVILLE CA
95661-2849
US

IV. Provider business mailing address

1520 EUREKA RD STE 102
ROSEVILLE CA
95661-2849
US

V. Phone/Fax

Practice location:
  • Phone: 209-689-8559
  • Fax: 916-462-3130
Mailing address:
  • Phone: 209-689-8559
  • Fax: 916-462-3130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT84298
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: