Healthcare Provider Details

I. General information

NPI: 1477697332
Provider Name (Legal Business Name): KIM SALUGAO NARVAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 N COTTONWOOD ST STE 1500
WOODLAND CA
95695-6646
US

IV. Provider business mailing address

PO BOX 191392
SACRAMENTO CA
95819-1392
US

V. Phone/Fax

Practice location:
  • Phone: 530-666-8630
  • Fax:
Mailing address:
  • Phone: 916-346-9961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberINTERN# 59396
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number82436
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: