Provider Demographics
NPI:1790436699
Name:KAYSON, EMILY CELESTE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CELESTE
Last Name:KAYSON
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 1:2430 K ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5032
Mailing Address - Country:US
Mailing Address - Phone:916-234-6720
Mailing Address - Fax:
Practice Address - Street 1:2430 K ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5032
Practice Address - Country:US
Practice Address - Phone:916-234-6720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist