Healthcare Provider Details

I. General information

NPI: 1154145936
Provider Name (Legal Business Name): MIND MATTERS CENTER, LICENSED CLINICAL SOCIAL WORKER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 21ST ST # 10173
SACRAMENTO CA
95811-5226
US

IV. Provider business mailing address

1401 21ST ST # 10173
SACRAMENTO CA
95811-5226
US

V. Phone/Fax

Practice location:
  • Phone: 562-600-0120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: YAJUN ZENG
Title or Position: CEO
Credential:
Phone: 415-379-0835