Provider Demographics
NPI:1801331822
Name:TOWNSEND, MARGRETTE ELAINE (PSB94023890)
Entity type:Individual
Prefix:
First Name:MARGRETTE
Middle Name:ELAINE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PSB94023890
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2379 STONE RIVER CT
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6203
Mailing Address - Country:US
Mailing Address - Phone:916-213-3944
Mailing Address - Fax:
Practice Address - Street 1:2379 STONE RIVER CT
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670
Practice Address - Country:US
Practice Address - Phone:916-213-3944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94023890103TC1900X
CAIMF 73837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling