Provider Demographics
NPI:1033626692
Name:CUMMINGS, ADRA MARIE (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:ADRA
Middle Name:MARIE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PRAIRIE CT # 1200
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-9998
Mailing Address - Country:US
Mailing Address - Phone:916-572-1208
Mailing Address - Fax:
Practice Address - Street 1:200 PRAIRIE CT # 1200
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-9998
Practice Address - Country:US
Practice Address - Phone:916-572-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103329106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist