Provider Demographics
NPI:1447371059
Name:BOYD, JUDITH M (LMFC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:BOYD
Suffix:
Gender:F
Credentials:LMFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5148 FREDERICKSBURG WY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835
Mailing Address - Country:US
Mailing Address - Phone:916-300-6859
Mailing Address - Fax:916-561-6701
Practice Address - Street 1:5148 FREDERICKSBURG WY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835
Practice Address - Country:US
Practice Address - Phone:916-300-6859
Practice Address - Fax:916-561-6701
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 30569106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist