Healthcare Provider Details

I. General information

NPI: 1912762436
Provider Name (Legal Business Name): DLB THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 09/01/2024
Certification Date: 09/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST # 8531
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

2108 N ST # 8531
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 925-217-7943
  • Fax:
Mailing address:
  • Phone: 925-217-7943
  • 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: DEVON RANKIN
Title or Position: OWNER
Credential:
Phone: 925-488-7211