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General NPI Number Information
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NPI Number | 1427594399
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Entity Type | Organization
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Legal Business Name | TODD PALUMBO MFT
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Dates
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Enumeration Date | 01/16/2017
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 3750 AUBURN BLVD STE C
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City | SACRAMENTO
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State | CA
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Zip | 95821-2134
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Country | US
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Telephone | 916-235-3717
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Fax |
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Provider Business Mailing Address
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Address Line | 4120 DOUGLAS BLVD STE 306-103
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City | GRANITE BAY
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State | CA
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Zip | 95746-5936
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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 | OWNER
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Name | TODD PALUMBO
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Credential |
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Telephone | 916-235-3717
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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 | LMFT49981
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License Number State | CA
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