Provider Demographics
NPI:1871605881
Name:TERRA NOVA COUNSELING
Entity type:Organization
Organization Name:TERRA NOVA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-344-0249
Mailing Address - Street 1:7844 MADISON AVE STE 152
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3540
Mailing Address - Country:US
Mailing Address - Phone:916-344-0249
Mailing Address - Fax:
Practice Address - Street 1:7844 MADISON AVE STE 152
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3540
Practice Address - Country:US
Practice Address - Phone:916-344-0249
Practice Address - Fax:916-344-0739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000008462OtherMEDI-CAL PROVIDER #