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General NPI Number Information
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NPI Number | 1760208136
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Entity Type | Individual
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Provider Name | JUSTIN DEE HARNDEN
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Gender | Male
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 3820 AUBURN BLVD STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95821-2124
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Country | US
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Telephone | 916-300-6576
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Fax |
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Provider Business Mailing Address
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Address Line | 3289 SUNNY GATE LN
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City | FOLSOM
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State | CA
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Zip | 95630-7055
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Country | US
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Telephone | 916-996-3207
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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