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General NPI Number Information
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NPI Number | 1043344765
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Entity Type | Organization
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Legal Business Name | PLACER COUNTY ASOC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11533 C AVE
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City | AUBURN
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State | CA
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Zip | 95603-2703
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Country | US
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Telephone | 530-889-7227
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8039
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City | AUBURN
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State | CA
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Zip | 95604-8039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM SUPERVISOR
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Name | MR. WILLIAM C THOMAS
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Credential | MFT
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Telephone | 916-889-7227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT 31841
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License Number State | CA
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