Provider Demographics
NPI:1306559042
Name:FAMILY THERAPY SOLUTIONS, INC
Entity type:Organization
Organization Name:FAMILY THERAPY SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JAYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-441-8398
Mailing Address - Street 1:PO BOX 2033
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93613-2033
Mailing Address - Country:US
Mailing Address - Phone:559-825-1098
Mailing Address - Fax:
Practice Address - Street 1:1648 GETTYSBURG AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4541
Practice Address - Country:US
Practice Address - Phone:559-825-1098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty