Healthcare Provider Details

I. General information

NPI: 1215864228
Provider Name (Legal Business Name): PEPPER TREE THERAPY LICESNED CLINICAL SOCIAL WORKER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 HIDDEN VALLEY RD
ROYAL OAKS CA
95076-9272
US

IV. Provider business mailing address

135 HIDDEN VALLEY RD
ROYAL OAKS CA
95076-9272
US

V. Phone/Fax

Practice location:
  • Phone: 831-288-1954
  • Fax: 408-877-1735
Mailing address:
  • Phone: 831-288-1954
  • Fax: 408-877-1735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TONAMEYOTZIN GONZALEZ KARLSSON
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 831-239-5757