| Doctor Name: | PAMELA SUE MAXWELL |
| NPI Number: | 1134344427 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC II |
| License Number: | A8378304 |
| Business Practice Address: | 500 Jefferson Blvd Ste B195 West Sacramento, CA - 956052350 |
| Business Phone Number: | 9164032970 |
| Business Fax Number: | 5302045255 |
| Mailing Address: | Po Box 233462, SACRAMENTO |
| State: | CA |
| Postal Code: | 958230441 |
| Phone Number: | 9162061721 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 12/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | A8378304 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |