Provider Demographics
NPI:1881187268
Name:TRIGG, MARYAH RENEE (LPT)
Entity Type:Individual
Prefix:
First Name:MARYAH
Middle Name:RENEE
Last Name:TRIGG
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3947 LENNANE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1971
Mailing Address - Country:US
Mailing Address - Phone:916-283-8280
Mailing Address - Fax:916-283-8259
Practice Address - Street 1:3947 LENNANE DR STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1971
Practice Address - Country:US
Practice Address - Phone:916-283-8280
Practice Address - Fax:916-283-8259
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37424167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician