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General NPI Number Information
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NPI Number | 1588538672
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Entity Type | Organization
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Legal Business Name | SHAMAH SHALOM MARRIAGE AND FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1531 CORPORATE WAY
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City | SACRAMENTO
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State | CA
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Zip | 95831-3888
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Country | US
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Telephone | 916-720-1097
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 221534
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City | SACRAMENTO
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State | CA
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Zip | 95822-8534
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Country | US
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Telephone | 916-720-1097
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOCELYN WILSON
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Credential | LMFT
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Telephone | 916-720-1097
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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 |
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License Number State |
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