Provider Demographics
NPI:1891948691
Name:ZUCKERMAN, MICHELLE R (LMFT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:ZUCKERMAN
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:R
Other - Last Name:BJARNARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 EUREKA RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2849
Mailing Address - Country:US
Mailing Address - Phone:209-689-8559
Mailing Address - Fax:209-465-2709
Practice Address - Street 1:1520 EUREKA RD STE 102
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2849
Practice Address - Country:US
Practice Address - Phone:209-689-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist