| Parents Place | |
|
1360 N Dutton Ave Suite C Santa Rosa CA 95401-4687 | |
| (707) 571-8131 | |
| (707) 571-8195 |
| Full Name | Parents Place |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1360 N Dutton Ave, Santa Rosa, California |
| Authorized Official Name and Position | Lynne W. Joachim (CLINICAL COUNSELOR) |
| Authorized Official Contact | 7075718131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parents Place 1360 N Dutton Ave Suite C Santa Rosa CA 95401-4687 Ph: (707) 571-8131 | Parents Place 1360 N Dutton Ave Suite C Santa Rosa CA 95401-4687 Ph: (707) 571-8131 |
| NPI Number | 1336203355 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336203355 | NPI | - | NPPES |
| MFC 24484 | Other | CA | LICENSE MFT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MFC24484 (California) | Primary |
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