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DR. SAM VICKERY PH.D. NPI 1710439591


NPI Information

NPI: 1710439591
Provider Name: DR. SAM VICKERY, PH.D.
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Individual
Address:
5015 CANYON CREST DR STE 112
RIVERSIDE, CA
ZIP 92507
Phone: (951) 781-0510
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DR. Sam Vickery, PH.D. is a marriage family therapist in Riverside, CA. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. DR. Sam Vickery, PH.D. NPI is 1710439591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5015 CANYON CREST DR STE 112
RIVERSIDE, CA
ZIP 92507-020
Phone: (951) 781-0510
Fax: (951) 784-7711

The enumeration date for this NPI number is 10/27/2016 and was last updated on 10/27/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthNo
2106H00000XMarriage & Family TherapistLMFT14375CALIFORNIAYes

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: 4/28/2024

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