Healthcare Provider Details

I. General information

NPI: 1366163370
Provider Name (Legal Business Name): AMBER CHILDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER M. CHILDS AMBER M. LITTLE

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3947 LENNANE DR STE 110411
SACRAMENTO CA
95834-1957
US

IV. Provider business mailing address

3947 LENNANE DR STE 110
SACRAMENTO CA
95834-1971
US

V. Phone/Fax

Practice location:
  • Phone: 916-283-8280
  • Fax: 916-283-8259
Mailing address:
  • Phone: 916-283-8280
  • Fax: 916-283-8259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160152
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: