Healthcare Provider Details

I. General information

NPI: 1144036286
Provider Name (Legal Business Name): TWISTED ROOTS MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E SANTA CLARA ST STE 13
VENTURA CA
93001-5972
US

IV. Provider business mailing address

2108 N ST STE C
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 805-366-3232
  • Fax:
Mailing address:
  • Phone: 805-366-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CRAIG MELTON
Title or Position: OWNER
Credential: LMFT
Phone: 805-366-3232