Provider Demographics
NPI:1063739126
Name:BOBBITT, CHARLOTTE JOAN (LMFT)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:JOAN
Last Name:BOBBITT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:JOAN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3017 DOUGLAS BVD.
Mailing Address - Street 2:300
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4241
Mailing Address - Country:US
Mailing Address - Phone:916-847-2059
Mailing Address - Fax:
Practice Address - Street 1:3017 DOUGLAS BVD.
Practice Address - Street 2:300
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4241
Practice Address - Country:US
Practice Address - Phone:916-847-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist