Healthcare Provider Details

I. General information

NPI: 1669323143
Provider Name (Legal Business Name): BREAKING GROUND PSYCHOTHERAPY AND WELLNESS, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 21ST ST STE 204
PASO ROBLES CA
93446-1722
US

IV. Provider business mailing address

8320 SHIRDON PL
PASO ROBLES CA
93446-8363
US

V. Phone/Fax

Practice location:
  • Phone: 805-835-2078
  • Fax:
Mailing address:
  • Phone: 805-835-2078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALISHA DOZIER
Title or Position: OWNER
Credential: LCSW
Phone: 805-835-9109