Basic Information
Provider Information
NPI: 1962522516
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMSON
FirstName: PAMELA
MiddleName: TONI
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9343 TECH CENTER DR.
Address2: 2ND FLOOR
City: SACRAMENTO
State: CA
PostalCode: 95826
CountryCode: US
TelephoneNumber: 9163886400
FaxNumber: 9165312863
Practice Location
Address1: 9343 TECH CENTER DR.
Address2: 2ND FLOOR
City: SACRAMENTO
State: CA
PostalCode: 95826
CountryCode: US
TelephoneNumber: 9163886400
FaxNumber: 9165312863
Other Information
ProviderEnumerationDate: 03/29/2007
LastUpdateDate: 04/05/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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