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General NPI Number Information
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NPI Number | 1518190024
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Entity Type | Individual
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Provider Name | JOHANNA PREIS M.S., IMFT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 420 FOLSOM RD STE C
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City | ROSEVILLE
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State | CA
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Zip | 95678-2767
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Country | US
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Telephone | 916-783-4950
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 SIERRA BLVD APT 27
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City | SACRAMENTO
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State | CA
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Zip | 95825-4817
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Country | US
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Telephone | 916-606-2189
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFTI # 60976
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License Number State | CA
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