Basic Information
Provider Information
NPI: 1851424626
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DALZIEL
FirstName: JUDITH
MiddleName: ARGALL
NamePrefix: MS.
NameSuffix:  
Credential: MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 191362
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958191362
CountryCode: US
TelephoneNumber: 9164479300
FaxNumber: 9164479210
Practice Location
Address1: 1330 21ST STREET
Address2: SUITE 201
City: SACRAMENTO
State: CA
PostalCode: 958144224
CountryCode: US
TelephoneNumber: 9164479300
FaxNumber: 9164479210
Other Information
ProviderEnumerationDate: 03/13/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMFC36499CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


Home