Provider Demographics
NPI:1952533978
Name:ROOD, TIMOTHY BENNETT (LMFT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:BENNETT
Last Name:ROOD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 FAIR OAKS BOULEVARD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628
Mailing Address - Country:US
Mailing Address - Phone:916-804-7334
Mailing Address - Fax:916-864-4204
Practice Address - Street 1:10120 FAIR OAKS BOULEVARD
Practice Address - Street 2:SUITE C
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628
Practice Address - Country:US
Practice Address - Phone:916-804-7334
Practice Address - Fax:916-864-4204
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34489106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist