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General NPI Number Information
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NPI Number | 1679389696
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Entity Type | Organization
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Legal Business Name | INSIGHTFUL CONNECTIONS MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORP
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1833 W MARCH LN STE 6
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City | STOCKTON
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State | CA
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Zip | 95207-6415
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Country | US
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Telephone | 209-317-8440
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 N ST STE N
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 209-317-8440
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | KAYLEEN A RAMIREZ-GARCIA
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Credential |
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Telephone | 650-380-3991
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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 |
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License Number State |
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