Provider Demographics
NPI:1639565633
Name:ELSON, SAMUEL TURNER (AMFT)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:TURNER
Last Name:ELSON
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4572
Mailing Address - Country:US
Mailing Address - Phone:530-341-8180
Mailing Address - Fax:
Practice Address - Street 1:105 E ST STE 2E
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4572
Practice Address - Country:US
Practice Address - Phone:530-341-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist