Provider Demographics
NPI:1588921589
Name:THE CHILD & FAMILY THERAPY PLACE, INC
Entity type:Organization
Organization Name:THE CHILD & FAMILY THERAPY PLACE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LIVIER
Authorized Official - Last Name:GUARDADO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:831-272-2041
Mailing Address - Street 1:1522 CONSTITUTION BLVD
Mailing Address - Street 2:#114
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-3803
Mailing Address - Country:US
Mailing Address - Phone:831-272-2041
Mailing Address - Fax:
Practice Address - Street 1:9 W GABILAN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2769
Practice Address - Country:US
Practice Address - Phone:831-272-2041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51117106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty