Basic Information
| Provider Information | |||||||||
| NPI: | 1093370066 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALBUSCHE | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7275 E SOUTHGATE DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958232610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164277141 | ||||||||
| FaxNumber: | 9164383034 | ||||||||
| Practice Location | |||||||||
| Address1: | 3161 DWIGHT RD | ||||||||
| Address2: | |||||||||
| City: | ELK GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957586456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164277141 | ||||||||
| FaxNumber: | 9164383034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2019 | ||||||||
| LastUpdateDate: | 09/30/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 02/08/2021 | ||||||||
| NPIReactivationDate: | 03/12/2021 | ||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 106S00000X | N | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101YM0800X | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.