Healthcare Provider Details

I. General information

NPI: 1801977319
Provider Name (Legal Business Name): ASSOCIATED THERAPISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5762 BOLSA AVE. SUITE 107
HUNTINGTON BEACH CA
92649-1172
US

IV. Provider business mailing address

5762 BOLSA AVE. SUITE 107
HUNTINGTON BEACH CA
92649-1172
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-0362
  • Fax: 714-893-3267
Mailing address:
  • Phone: 714-898-0362
  • Fax: 714-893-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: JULIO GUERRA
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 714-898-0362