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General NPI Number Information
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NPI Number | 1942776612
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Entity Type | Individual
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Provider Name | RYAN ANDREW LISTBERGER AMFT
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Gender | Male
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 6518 LONETREE BLVD
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City | ROCKLIN
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State | CA
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Zip | 95765-5874
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Country | US
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Telephone | 916-770-9053
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Fax |
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Provider Business Mailing Address
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Address Line | 993 HOPKINS ST
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City | LINCOLN
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State | CA
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Zip | 95648-8828
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Country | US
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Telephone | 916-337-9638
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 155564
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License Number State | CA
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