| NPI | 1982135265 |
|---|---|
| Doing Business As | LIFE TREE |
| Doing Business As | LIFE TREE PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | JOSH HOOTON Owner/Provider 805-504-6665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care (Licence: UT 6227164-4405) | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2019-10-21 |