Provider Demographics
NPI:1427189521
Name:WELLS, COURTNEY ANN
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:ANN
Last Name:WELLS
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 1:5160 AUBURN FOLSOM RD
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-5891
Mailing Address - Country:US
Mailing Address - Phone:916-613-8214
Mailing Address - Fax:
Practice Address - Street 1:5523 34TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-4725
Practice Address - Country:US
Practice Address - Phone:916-452-3601
Practice Address - Fax:916-453-2829
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor