Provider Demographics
NPI:1992453245
Name:ORACLE OAK FAMILY THERAPY
Entity type:Organization
Organization Name:ORACLE OAK FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNI
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:530-355-0115
Mailing Address - Street 1:353 PARK MARINA CIR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0965
Mailing Address - Country:US
Mailing Address - Phone:530-355-0115
Mailing Address - Fax:530-245-0992
Practice Address - Street 1:353 PARK MARINA CIR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0965
Practice Address - Country:US
Practice Address - Phone:530-355-0115
Practice Address - Fax:530-245-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty