Provider Demographics
NPI:1932467677
Name:ALTERI, WANDA G (LMFT)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:G
Last Name:ALTERI
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 1:1002 RIVER ROCK DR
Mailing Address - Street 2:221
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2094
Mailing Address - Country:US
Mailing Address - Phone:916-947-6657
Mailing Address - Fax:
Practice Address - Street 1:1002 RIVER ROCK DR
Practice Address - Street 2:221
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2094
Practice Address - Country:US
Practice Address - Phone:916-947-6657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37218106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37218OtherMFC