SUPPORT FOR YOUR LIFE NPI 1255034203

NPI Information

  • NPI: 1255034203
  • Provider Name: SUPPORT FOR YOUR LIFE
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 701 HIGH ST STE 227
    AUBURN, CA
    ZIP 95603
  • Phone: (530) 500-5885

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NPI Details

SUPPORT FOR YOUR LIFE is a clinical psychologist in Auburn, CA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SUPPORT FOR YOUR LIFE NPI is 1255034203. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

701 HIGH ST STE 227
AUBURN, CA
ZIP 95603-727
Phone: (530) 500-5885
Fax: (530) 500-4748

The provider's authorized official is Kristin Lyn Kaminski-wadle .
The authorized official title is Director and has the following contact phone number (530) 500-5885.

The enumeration date for this NPI number is 3/27/2023 and was last updated on 3/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical NeuropsychologistNo
2103TA0700XPsychologistAdult Development & AgingNo
3103TB0200XPsychologistCognitive & BehavioralNo
4103TC2200XPsychologistClinical Child & AdolescentNo
5103TF0000XPsychologistFamilyNo
6103TC0700XPsychologistClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11245779552OTHERNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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