Healthcare Provider Details

I. General information

NPI: 1023441607
Provider Name (Legal Business Name): WITH THERAPY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15951 LOS GATOS BLVD STE 14
LOS GATOS CA
95032-3488
US

IV. Provider business mailing address

15951 LOS GATOS BLVD STE 14
LOS GATOS CA
95032-3488
US

V. Phone/Fax

Practice location:
  • Phone: 408-596-4940
  • Fax: 408-689-5143
Mailing address:
  • Phone: 408-596-4940
  • Fax: 408-689-5143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY23529
License Number StateCA

VIII. Authorized Official

Name: DR. AMANDA WITHROW
Title or Position: OWNER/SOLE PROPRIETOR
Credential: PHD
Phone: 408-596-4940