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General NPI Number Information
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NPI Number | 1548372709
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Entity Type | Individual
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Provider Name | LISA KATHLEEN WOLFF LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 4320 AUBURN BLVD. SUITE 1200
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City | SACRAMENTO
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State | CA
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Zip | 95841
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Country | US
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Telephone | 916-922-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 FENTON WAY
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City | GRANITE BAY
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State | CA
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Zip | 95746
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Country | US
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Telephone | 858-284-9097
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | RCOOO38558
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License Number State | WA
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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 | IMF91343
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License Number State | CA
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