Provider Demographics
NPI:1558989327
Name:ZACHMAN, SAMANTHA JANE (MS, AMFT #108783)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:JANE
Last Name:ZACHMAN
Suffix:
Gender:F
Credentials:MS, AMFT #108783
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 LONETREE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5701 LONETREE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3794
Practice Address - Country:US
Practice Address - Phone:833-432-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108783101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health