Organization Active NPI

Pacific Counseling and Trauma Center

  • Marriage & Family Therapist
  • Folsom, CA
National Provider Identifier
1053703280
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
37375 Issued in CA
Legal business name
PACIFIC COUNSELING AND TRAUMA CENTER
Practice address
706 Natoma St
Folsom, CA 95630-3074
Phone
(916) 608-4569
NPI assigned
Feb 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Larson, MFCC
Title
Owner
Phone
(916) 712-0226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 37375 CA Primary

Addresses

Primary practice location

706 Natoma St
Folsom, CA 95630-3074

Mailing address

706 Natoma St
Folsom, CA 95630-3074
Phone (916) 608-4569

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1053703280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 NATOMA ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303074",
            "telephone_number": "916-608-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 NATOMA ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303074",
            "telephone_number": "916-608-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COUNSELING AND TRAUMA CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-712-0226",
        "authorized_official_credential": "MFCC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "37375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.