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NPI Code Detail

MEDICARE: MS. CHARLOTTE ADAMS MFT INTERN

MEDICARE: MS. CHARLOTTE ADAMS MFT INTERN
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
1106H00000XMarriage & Family TherapistIMF47052CA

General Provider Information

NPI Number : 1619084043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHARLOTTE ADAMS MFT INTERN
Provider Business Mailing Address
First Line : 2616 MARSH WREN WAY
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-8185
Country : US
Telephone Number : 916-685-3238
Fax Number :
Provider Business Practice Location Address
First Line : 3307 BROADWAY STE 200
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2821
Country : US
Telephone Number : 916-454-4242
Fax Number : 916-454-2930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/08/2007

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Directions to “ MS. CHARLOTTE ADAMS MFT INTERN” Practice Location

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