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General NPI Number Information
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NPI Number | 1265390868
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Entity Type | Individual
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Provider Name | AGNES CZAJA AMFT
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Gender | Female
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | PO BOX 910
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City | SEBASTOPOL
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State | CA
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Zip | 95473-0910
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Country | US
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Telephone | 707-666-5170
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Fax | 530-687-8200
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Provider Business Mailing Address
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Address Line | 314 PERKINS ST APT 106
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City | OAKLAND
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State | CA
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Zip | 94610-3452
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Country | US
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Telephone | 707-666-5170
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Fax | 530-687-8200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AMFT160897
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License Number State | CA
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