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General NPI Number Information
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NPI Number | 1194629659
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Entity Type | Organization
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Legal Business Name | CHICK THERAPY
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 4401 GATEWAY PARK BLVD STE 130
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City | SACRAMENTO
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State | CA
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Zip | 95834-2473
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Country | US
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Telephone | 707-410-6983
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 GATEWAY PARK BLVD STE 130
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City | SACRAMENTO
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State | CA
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Zip | 95834-2473
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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 | EXECUTIVE DIRECTOR
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Name | ANGELA MARIE WASHINGTON
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Credential |
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Telephone | 707-410-6983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | NULL
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