Healthcare Provider Details

I. General information

NPI: 1215710306
Provider Name (Legal Business Name): LOREANN TALBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 K ST STE 125
SACRAMENTO CA
95816-5133
US

IV. Provider business mailing address

2617 K ST STE 125
SACRAMENTO CA
95816-5133
US

V. Phone/Fax

Practice location:
  • Phone: 916-633-0854
  • Fax:
Mailing address:
  • Phone: 916-633-0854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151263
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: