Individual
ALICIA FAITH SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 FAIR AVE, SANTA CRUZ, CA 95060-5828
(831) 427-1007
(831) 454-0545
Mailing address
707 FAIR AVE, SANTA CRUZ, CA 95060-5828
(831) 427-1007
(831) 454-0545
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YA0400X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YA0400X
MEDICAL
CA
Enumeration date
11/22/2022
Last updated
11/22/2022
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