Provider Demographics
NPI:1912357922
Name:SALE, TESSA ROSE
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:ROSE
Last Name:SALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:ROSE
Other - Last Name:SALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1742 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1717
Mailing Address - Country:US
Mailing Address - Phone:530-226-7419
Mailing Address - Fax:
Practice Address - Street 1:1742 OREGON ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1717
Practice Address - Country:US
Practice Address - Phone:530-226-7419
Practice Address - Fax:530-224-9433
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92917106H00000X
CA111203106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist