Provider Demographics
NPI:1811672124
Name:ZEPHYR THERAPY LLC
Entity type:Organization
Organization Name:ZEPHYR THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-663-2804
Mailing Address - Street 1:3340 CRESTFORD DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-4112
Mailing Address - Country:US
Mailing Address - Phone:310-663-2804
Mailing Address - Fax:
Practice Address - Street 1:4784 N LOMBARD ST STE B1029
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-4565
Practice Address - Country:US
Practice Address - Phone:310-663-2804
Practice Address - Fax:626-298-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty