Provider Demographics
NPI:1619390291
Name:MCMULLEN, SAMANTHA CHEZ BABCOCK (LMFT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CHEZ BABCOCK
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 BURNT RANCH WAY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8293
Mailing Address - Country:US
Mailing Address - Phone:408-605-9874
Mailing Address - Fax:
Practice Address - Street 1:636 BURNT RANCH WAY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8293
Practice Address - Country:US
Practice Address - Phone:408-605-9874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-02
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA124825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)