Healthcare Provider Details

I. General information

NPI: 1356264501
Provider Name (Legal Business Name): COOK FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 21ST ST # 16313
SACRAMENTO CA
95811-5226
US

IV. Provider business mailing address

22431 ANTONIO PKWY B160-198
RANCHO SANTA MARGARITA CA
92688-2804
US

V. Phone/Fax

Practice location:
  • Phone: 949-838-4804
  • Fax:
Mailing address:
  • Phone: 949-838-4804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ALYSSA COOK
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: M.A., LMFT
Phone: 949-838-4804