Healthcare Provider Details
I. General information
NPI: 1750168043
Provider Name (Legal Business Name): CITY OF TREES ASSESSMENT AND PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2023
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 FULTON AVE STE 218
SACRAMENTO CA
95825-4299
US
IV. Provider business mailing address
9311 DEFIANCE CIR
SACRAMENTO CA
95827-1011
US
V. Phone/Fax
- Phone: 916-224-6820
- Fax:
- Phone: 330-317-9274
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HALEIGH
SCOTT
Title or Position: CEO
Credential: PH.D
Phone: 916-913-1542