MEDICARE: AMBER CHOISELLA THUSTON MSC, LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	APCC5461	CA
2	101YM0800X	Mental Health Counselor	LPCC13283	CA

General Provider Information

NPI Number	:	1245776855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER CHOISELLA THUSTON MSC, LPCC

Provider Business Mailing Address
First Line	:	2610 FOOTHILL DR
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-4259
Country	:	US
Telephone Number	:	916-266-3518
Fax Number	:

Provider Business Practice Location Address
First Line	:	948 SACRAMENTO AVE
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95605
Country	:	US
Telephone Number	:	916-254-0650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	02/23/2023

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