| Tlc Child & Family Services | |
|
1800 Gravenstein Hwy N Bldg Ef Sebastopol CA 95472-2607 | |
| (707) 634-9050 | |
| Not Available |
| Full Name | Tlc Child & Family Services |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1800 Gravenstein Hwy N Bldg Ef, Sebastopol, California |
| Authorized Official Name and Position | Alexandra Mondragon (ACCOUNT MANAGER) |
| Authorized Official Contact | 7076349037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Child & Family Services 1800 Gravenstein Hwy N. Sebastopol CA 95472-2607 Ph: () - | Tlc Child & Family Services 1800 Gravenstein Hwy N Bldg Ef Sebastopol CA 95472-2607 Ph: (707) 634-9050 |
| NPI Number | 1073131942 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 06/01/2022 |
| Certification Date | 05/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073131942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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