Provider Demographics
NPI:1275320889
Name:HORN, MICHAEL ALAN (MA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:HORN
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3578 DEVON WAY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-6200
Mailing Address - Country:US
Mailing Address - Phone:559-977-5289
Mailing Address - Fax:
Practice Address - Street 1:8303 SIERRA COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95661-9485
Practice Address - Country:US
Practice Address - Phone:916-746-7235
Practice Address - Fax:916-746-7235
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139240106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist