Provider Demographics
NPI:1316630114
Name:LA PAZ COUNSELING & THERAPY SERVICES
Entity type:Organization
Organization Name:LA PAZ COUNSELING & THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:IMELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONATO
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:209-440-0143
Mailing Address - Street 1:PO BOX 693133
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95269-3133
Mailing Address - Country:US
Mailing Address - Phone:209-440-0143
Mailing Address - Fax:
Practice Address - Street 1:3108 W HAMMER LN STE B
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-2752
Practice Address - Country:US
Practice Address - Phone:209-440-0143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health