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General NPI Number Information
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NPI Number | 1053203877
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Entity Type | Organization
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Legal Business Name | THE THERAPEUTIC COLLECTIVE, A PROFESSIONAL PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 9712 FAIR OAKS BLVD STE C3
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City | FAIR OAKS
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State | CA
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Zip | 95628-7032
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Country | US
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Telephone | 916-919-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 9712 FAIR OAKS BLVD STE C3
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City | FAIR OAKS
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State | CA
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Zip | 95628-7032
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Country | US
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Telephone | 916-919-0693
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST, CEO, CFO, SE
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Name | DR. ANDREA L BRUCE
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Credential | PHD
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Telephone | 916-919-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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