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General NPI Number Information
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NPI Number | 1134437148
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Entity Type | Organization
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Legal Business Name | DISCOVERY PSYCHOTHERAPY CENTER, INC.
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 4120 CAMERON PARK DR SUITE 301
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City | CAMERON PARK
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State | CA
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Zip | 95682-8480
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Country | US
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Telephone | 530-676-4445
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Fax |
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Provider Business Mailing Address
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Address Line | 4120 CAMERON PARK DR SUITE 301
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City | CAMERON PARK
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State | CA
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Zip | 95682-8480
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Country | US
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Telephone | 530-676-4445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BARBARA E. THOMPSON
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Credential | M.A.
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Telephone | 530-676-4445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC21925
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License Number State | CA
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