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LIFE SOURCE, INC.
NPI 1619098332
Counselor - Mental Health in Roseville, CA

Active since April 02, 2007
2530 DOUGLAS BLVD, SUITE 160, ROSEVILLE, CA 95661(916) 784-0110 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Life Source, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE SOURCE, INC. (NPI 1619098332) is a healthcare organization registered as a mental health in Roseville, California and active in the NPI registry since April 2007. The organization lists Orville E Easterly, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1619098332
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameLIFE SOURCE, INC.
Location Address2530 DOUGLAS BLVD, SUITE 160Roseville, CA 95661-3989
Mailing Address2530 Douglas Blvd, Suite 160Roseville, CA 95661-3989 · (916) 784-0110
Phone(916) 784-0110
Organization SubpartNo
Authorized OfficialOrville E EasterlyClinical Director · (916) 784-0110
Enumeration DateApril 2, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1619098332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2530 DOUGLAS BLVD, Roseville, CA 95661
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANE WELDON CCC-SLP
Speech-Language Pathologist
2530 DOUGLAS BLVD, SUITE 130
ROSEVILLE, CA 95661
Placer County (916) 797-3307
MICHAEL MOLINO SLP
Speech-Language Pathologist
2530 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 797-3307
NINA KAE FUCILE S.L.P.
Speech-Language Pathologist
2530 DOUGLAS BLVD
ROSEVILLE, CA 95661
Placer County (916) 797-3307

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Source, Inc.'s NPI number?

The NPI number for Life Source, Inc. is 1619098332. It was assigned to this organization in the NPPES registry on April 2, 2007.

Where is Life Source, Inc. located?

Life Source, Inc. is located at 2530 Douglas Blvd Suite 160, Roseville, CA 95661. The listed phone number is (916) 784-0110.

What is Life Source, Inc.'s specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Life Source, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.