Healthcare Provider Details

I. General information

NPI: 1265348981
Provider Name (Legal Business Name): AVENIR PSYCHOLOGY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

4010 TRUXEL RD STE 185
SACRAMENTO CA
95834-3795
US

IV. Provider business mailing address

4010 TRUXEL RD STE 185
SACRAMENTO CA
95834-3795
US

V. Phone/Fax

Practice location:
  • Phone: 916-915-3007
  • Fax:
Mailing address:
  • Phone: 916-915-3007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: ISHA HAMMAD
Title or Position: PSYCHOLOGIST/OWNER
Credential: PHD
Phone: 916-915-3007