| NPI | 1902390537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE COFFEL Credentialing Specialist 707-328-3658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A48810) | |
| 103TC0700X Psychologist, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2026-04-10 |