Provider Demographics
NPI:1336433002
Name:SACRAMENTO PSYCHOTHERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:SACRAMENTO PSYCHOTHERAPY SERVICES, INC.
Other - Org Name:KURA BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:D
Authorized Official - Middle Name:CHADWICK
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:916-339-7443
Mailing Address - Street 1:3550 WATT AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2667
Mailing Address - Country:US
Mailing Address - Phone:916-339-7443
Mailing Address - Fax:916-359-0737
Practice Address - Street 1:3550 WATT AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2667
Practice Address - Country:US
Practice Address - Phone:916-339-7443
Practice Address - Fax:916-359-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-30
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPC 165101YP2500X
CAMFC 48044106H00000X
133N00000X, 251S00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty