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General NPI Number Information
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NPI Number | 1295054666
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Entity Type | Organization
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Legal Business Name | DEBRA J. TRIPP, LMFT
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 4801 J ST SUITE E
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City | SACRAMENTO
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State | CA
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Zip | 95819-3746
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Country | US
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Telephone | 916-456-4624
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Fax | 916-456-5648
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Provider Business Mailing Address
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Address Line | PO BOX 19037
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City | SACRAMENTO
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State | CA
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Zip | 95819-0037
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Country | US
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Telephone | 916-456-4624
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Fax | 916-456-5648
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Authorized Official
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Title or Position | OWNER
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Name | MS. DEBRA J TRIPP
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Credential | LMFT
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Telephone | 916-456-4624
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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 | MFC 37882
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License Number State | CA
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