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General NPI Number Information
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NPI Number | 1376565572
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Entity Type | Individual
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Provider Name | CARTER JOHN HAYNES MA, MFT, PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 3336 BRADSHAW RD # 320
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City | SACRAMENTO
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State | CA
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Zip | 95827-2615
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Country | US
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Telephone | 916-267-1458
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Fax | 916-273-5641
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Provider Business Mailing Address
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Address Line | PO BOX 276785
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City | SACRAMENTO
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State | CA
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Zip | 95827-6785
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Country | US
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Telephone | 916-267-1458
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Fax | 916-273-5641
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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 | MFC 35717
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License Number State | CA
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