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General NPI Number Information
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NPI Number | 1699462739
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Entity Type | Organization
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Legal Business Name | LIFE & LIBERATION CORP.
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 2740 FULTON AVE STE 100D
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City | SACRAMENTO
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State | CA
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Zip | 95821-5190
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Country | US
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Telephone | 650-804-2319
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Fax |
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Provider Business Mailing Address
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Address Line | 6115 CHRISTINA CT
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City | GRANITE BAY
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State | CA
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Zip | 95746-9039
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Country | US
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Telephone | 650-804-2319
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHEILA MCVEY
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Credential |
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Telephone | 530-622-1017
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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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