Healthcare Provider Details

I. General information

NPI: 1194629659
Provider Name (Legal Business Name): CHICK THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 GATEWAY PARK BLVD STE 130
SACRAMENTO CA
95834-2473
US

IV. Provider business mailing address

4401 GATEWAY PARK BLVD STE 130
SACRAMENTO CA
95834-2473
US

V. Phone/Fax

Practice location:
  • Phone: 707-410-6983
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANGELA MARIE WASHINGTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 707-410-6983