Provider Demographics
NPI:1093370066
Name:ALBUSCHE, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ALBUSCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3161 DWIGHT RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6456
Mailing Address - Country:US
Mailing Address - Phone:916-427-7141
Mailing Address - Fax:916-438-3034
Practice Address - Street 1:3161 DWIGHT RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-6456
Practice Address - Country:US
Practice Address - Phone:916-427-7141
Practice Address - Fax:916-438-3034
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2023-08-22
Deactivation Date:2021-02-08
Deactivation Code:
Reactivation Date:2021-03-12
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 106S00000X, 171M00000X, 101YP2500X
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator