MEDICARE: JUSTIN ALTMAN

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	106H00000X	Marriage & Family Therapist	IMF101502	CA
2	106H00000X	Marriage & Family Therapist	135806	CA

General Provider Information

NPI Number	:	1548590938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN ALTMAN

Provider Business Mailing Address
First Line	:	PO BOX 278702
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-8702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 ROSIN CT STE 170
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1656
Country	:	US
Telephone Number	:	916-567-4222
Fax Number	:

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

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	11/23/2022

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Directions to “ JUSTIN ALTMAN ” Practice Location

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