Provider Demographics
NPI:1295040970
Name:SOLACE COUNSELING MARRIAGE AND FAMILY THERAPY CALIFORNIA P C
Entity Type:Organization
Organization Name:SOLACE COUNSELING MARRIAGE AND FAMILY THERAPY CALIFORNIA P C
Other - Org Name:SOLACE COUNSELING MFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRIPP
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-456-4624
Mailing Address - Street 1:PO BOX 19037
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-0037
Mailing Address - Country:US
Mailing Address - Phone:916-456-4624
Mailing Address - Fax:916-456-5648
Practice Address - Street 1:4801 J ST
Practice Address - Street 2:SUITE E
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3746
Practice Address - Country:US
Practice Address - Phone:916-456-4624
Practice Address - Fax:916-456-5648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty