Organization
TERRA NOVA COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY K. STROUBE (CFO, PRESIDENT)
(916) 344-0964
Entity
Organization
Contact information
Practice address
5750 SUNRISE BLVD, CITRUS HEIGHTS, CA 95610-7634
(916) 334-4096
Mailing address
4700 NORTHGATE BLVD STE 122, SACRAMENTO, CA 95834-1148
(916) 564-0600
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000008462
MEDICALL PROVIDER #
CA
Enumeration date
12/11/2008
Last updated
03/23/2012
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