Provider Demographics
NPI:1164607099
Name:BUSHNELL, GRETCHEN ELIZABETH (MHA111)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:ELIZABETH
Last Name:BUSHNELL
Suffix:
Gender:F
Credentials:MHA111
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Other - Credentials:
Mailing Address - Street 1:7000 FRANKLIN BLVD
Mailing Address - Street 2:200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-1820
Mailing Address - Country:US
Mailing Address - Phone:916-394-9194
Mailing Address - Fax:916-392-2827
Practice Address - Street 1:7000 FRANKLIN BLVD
Practice Address - Street 2:200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1820
Practice Address - Country:US
Practice Address - Phone:916-394-9194
Practice Address - Fax:916-392-2827
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health