Organization
MAKENA THERAPY
Active
Other names
Sarah Rose, LMFT
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH ROSE LMFT (PRESIDENT)
(209) 346-7411
Entity
Organization
Contact information
Practice address
1660 W LINNE RD STE 223, TRACY, CA 95377-8004
(209) 346-7411
Mailing address
2455 NAGLEE RD STE 138, TRACY, CA 95304-7324
(209) 346-7411
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
01/13/2021
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