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General NPI Number Information
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NPI Number | 1619772852
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Entity Type | Organization
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Legal Business Name | SUMMIT PSYCHOTHERAPY ASSOCIATES, PC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3610 AMERICAN RIVER DR STE 140
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City | SACRAMENTO
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State | CA
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Zip | 95864-5919
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Country | US
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Telephone | 877-825-8584
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 561482
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City | DENVER
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State | CO
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Zip | 80256-1482
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Country | US
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Telephone | 303-731-8164
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Fax |
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Authorized Official
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Title or Position | MANAGER, CREDENTIALING & PAYOR STRA
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Name | MISS JESS JOSLIN
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Credential |
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Telephone | 303-731-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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