| NPI | 1285747048 |
|---|---|
| Former Legal Business Name | FAIR OAKS THERAPEUTICUM |
| Entity Type | Organization |
| Authorized Contact | URSULA R. STEHLE Clinical Director 916-962-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA PSY13576) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 13576) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFT 37218) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFT 47221) | |
| 163W00000X Registered Nurse (Licence: CA RN 427621) | |
| 106H00000X Marriage & Family Therapist (Licence: CA LMFT 50205) | |
| 163W00000X Registered Nurse (Licence: CA RN213291) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-01-28 |