Victoria A Campbell, LMFT

Individual provider Active NPI Marriage & Family Therapist · Soquel, CA

NPI 1891966602 · NPPES record last updated Aug 31, 2020

Key facts

NPI
1891966602
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
47586 (CA)
Practice address
4601 W Walnut St # MB4
Soquel, CA 95073-2460
Phone
(831) 588-7631
NPI assigned
Mar 19, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1472NVMDMarriage & Family Therapist
47586CAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1472 NV
Marriage & Family Therapist 106H00000X 47586 CA Yes

Addresses

Primary practice location

4601 W Walnut St # MB4
Soquel, CA 95073-2460

Mailing address

4601 W Walnut St # MB4
Soquel, CA 95073-2460
Phone (831) 588-7631

Other providers in Soquel, CA

All providers in Soquel, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.