Active NPI
Margo Angela Soderstrom
- Marriage & Family Therapist
- Sacramento, CA
National Provider Identifier
1124264791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 56434
- Practice address
- 4343 Williamsbourgh Dr
Sacramento, CA 95823-2006 - Phone
- (209) 688-5233
- NPI assigned
- Dec 31, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Marriage & Family Therapist | 106H00000X | IMF 56434 | CA | Primary |
Addresses
Primary practice location
4343 Williamsbourgh Dr
Sacramento, CA 95823-2006
Mailing address
4343 Williamsbourgh Dr
Sacramento, CA 95823-2006
Phone (209) 688-5233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 56434 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230681600000",
"number": "1124264791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4343 WILLIAMSBOURGH DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958232006",
"telephone_number": "209-688-5233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4343 WILLIAMSBOURGH DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958232006",
"telephone_number": "209-688-5233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SODERSTROM",
"first_name": "MARGO",
"middle_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-31",
"last_updated": "2008-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 56434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.