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NPI Code Detail

MEDICARE: MRS. GLADYS MARIE MITCHELL

MEDICARE: MRS. GLADYS MARIE MITCHELL
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
1101YM0800XMental Health CounselorASW120076CA

General Provider Information

NPI Number : 1861943201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GLADYS MARIE MITCHELL
Provider Business Mailing Address
First Line : 3050 BEACON BLVD
Second Line :
City : W SACRAMENTO
State : CA
Zip : 95691-3467
Country : US
Telephone Number : 916-462-3100
Fax Number :
Provider Business Practice Location Address
First Line : 3050 BEACON BLVD
Second Line :
City : W SACRAMENTO
State : CA
Zip : 95691-3467
Country : US
Telephone Number : 916-462-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2016
Last Update Date : 01/21/2026

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Directions to “ MRS. GLADYS MARIE MITCHELL ” Practice Location

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