NPIMap

Organization Active NPI

Sundance Life Enrichment, Inc.

  • Marriage & Family Therapist
  • Loomis, CA
National Provider Identifier
1063807113
Registry record updated Apr 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
50023 Issued in CA
Legal business name
SUNDANCE LIFE ENRICHMENT, INC.
Practice address
3875 Taylor Rd Ste 204G
Loomis, CA 95650-9273
Phone
(530) 401-2078
NPI assigned
Apr 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2015

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

Authorized official

Name
Shea Phinney Ridley
Title
President
Phone
(530) 401-2078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 50023 CA Primary

Addresses

Primary practice location

3875 Taylor Rd Ste 204G
Loomis, CA 95650-9273

Mailing address

PO Box 1525
Loomis, CA 95650-1525

National Provider Directory

National Provider Directory

Locations

3875 Taylor Rd
Ste 204G
Loomis, CA 95650
Phone (530) 401-2078

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428105600000",
    "number": "1063807113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1525",
            "city": "LOOMIS",
            "state": "CA",
            "postal_code": "956501525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 TAYLOR RD STE 204G",
            "city": "LOOMIS",
            "state": "CA",
            "postal_code": "956509273",
            "telephone_number": "530-401-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE LIFE ENRICHMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-04",
        "last_updated": "2015-04-04",
        "status": "A",
        "authorized_official_last_name": "PHINNEY RIDLEY",
        "authorized_official_first_name": "SHEA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-401-2078"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loomis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.