Provider Demographics
NPI:1528681830
Name:ROCHELLE PEARS MARRIAGE FAMILY THERAPIST
Entity type:Organization
Organization Name:ROCHELLE PEARS MARRIAGE FAMILY THERAPIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-276-4366
Mailing Address - Street 1:5150 SUNRISE BLVD STE G5
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4965
Mailing Address - Country:US
Mailing Address - Phone:916-847-0014
Mailing Address - Fax:
Practice Address - Street 1:5150 SUNRISE BLVD STE G5
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4965
Practice Address - Country:US
Practice Address - Phone:916-966-1812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty