Provider Demographics
NPI:1659814960
Name:CODY, MAURA CURTIN (LMFT)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:CURTIN
Last Name:CODY
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 1:13405 FOLSOM BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4737
Mailing Address - Country:US
Mailing Address - Phone:916-304-4638
Mailing Address - Fax:
Practice Address - Street 1:13405 FOLSOM BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4737
Practice Address - Country:US
Practice Address - Phone:916-304-4638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96179106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist