Provider Demographics
NPI:1821145434
Name:WAMPLER, RHONDA LEAH (MFT)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:LEAH
Last Name:WAMPLER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 BARTON RD
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9060
Mailing Address - Country:US
Mailing Address - Phone:916-652-4033
Mailing Address - Fax:916-652-3933
Practice Address - Street 1:411 OAK ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2618
Practice Address - Country:US
Practice Address - Phone:916-783-1331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39891106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist