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General NPI Number Information
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NPI Number | 1487252854
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Entity Type | Individual
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Provider Name | ELIZABETH JEAN GRANT BCBA, AMFT, APCC
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Gender | Female
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 9343 TECH CENTER DR STE 110 4604A ROOSEVELT AVE, SACRAMENTO CA 95820
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City | SACRAMENTO
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State | CA
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Zip | 95826-2592
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Country | US
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Telephone | 408-465-8280
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Fax |
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Provider Business Mailing Address
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Address Line | 9343 TECH CENTER DR STE 110
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City | SACRAMENTO
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State | CA
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Zip | 95826-2592
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Country | US
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Telephone | 408-465-8280
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-43158
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 154339
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 19264
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License Number State | CA
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