Provider Demographics
NPI:1407238926
Name:MARGETICH&MORTON MFCC
Entity Type:Organization
Organization Name:MARGETICH&MORTON MFCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARGETICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:916-920-9429
Mailing Address - Street 1:2277 FAIR OAKS BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5599
Mailing Address - Country:US
Mailing Address - Phone:916-920-9429
Mailing Address - Fax:916-929-9491
Practice Address - Street 1:2277 FAIR OAKS BLVD STE 190
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5599
Practice Address - Country:US
Practice Address - Phone:916-920-9429
Practice Address - Fax:916-929-9491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-20
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT20729106H00000X
CAMFT23393106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty