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General NPI Number Information
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NPI Number | 1992007710
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Entity Type | Individual
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Provider Name | MICHAEL SIMEN GINZBURG MA
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Gender | Male
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 3090 FITE CIR STE 102
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City | SACRAMENTO
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State | CA
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Zip | 95827-1810
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Country | US
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Telephone | 916-549-3466
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Fax |
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Provider Business Mailing Address
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Address Line | 3090 FITE CIR STE 102
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City | SACRAMENTO
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State | CA
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Zip | 95827-1810
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Country | US
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Telephone | 916-549-3466
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | CO004912
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 113095
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License Number State | CA
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