Provider Demographics
NPI:1063125789
Name:PATH OF COMPASSION FAMILY THERAPY
Entity type:Organization
Organization Name:PATH OF COMPASSION FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HUBBIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:FABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:916-695-0724
Mailing Address - Street 1:3235 FARALLON RD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5816
Mailing Address - Country:US
Mailing Address - Phone:916-695-0724
Mailing Address - Fax:
Practice Address - Street 1:3820 AUBURN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2124
Practice Address - Country:US
Practice Address - Phone:916-695-0724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083271159OtherNPI