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General NPI Number Information
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NPI Number | 1023747326
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Entity Type | Organization
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Legal Business Name | SIERRA CENTER FOR WELLESS SACRAMENTO A PSYCHOLOGIAL CORPORATION
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY AVE STE 225
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City | SACRAMENTO
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State | CA
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Zip | 95825-6756
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Country | US
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Telephone | 916-794-2051
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Fax | 916-794-2051
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Provider Business Mailing Address
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Address Line | 1215 LA SIERRA DR
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City | SACRAMENTO
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State | CA
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Zip | 95864-3049
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Country | US
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Telephone | 916-850-9472
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANTON PAULSON
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Credential | PH.D.
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Telephone | 916-794-2051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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