Organization
AMANDA GIBSON, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA DILLON (BILLING AND CREDENTIALING SPECIALIS)
(530) 277-7054
Entity
Organization
Contact information
Practice address
2617 K ST STE 125, SACRAMENTO, CA 95816-5133
(916) 633-0854
Mailing address
2617 K ST STE 125, SACRAMENTO, CA 95816-5133
(916) 633-0854
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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