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General NPI Number Information
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NPI Number | 1215159991
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Entity Type | Organization
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Legal Business Name | SEXUAL ASSAULT & DOMESTIC VIOLENCE CENTER
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 933 COURT STREET
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City | WOODLAND
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State | CA
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Zip | 95695
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Country | US
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Telephone | 530-661-6336
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Fax | 530-661-3021
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Provider Business Mailing Address
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Address Line | 933 COURT STREET
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City | WOODLAND
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State | CA
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Zip | 95695
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Country | US
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Telephone | 530-661-6336
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Fax | 530-661-3021
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Authorized Official
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Title or Position | DIRECTOR OF COUNSELING
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Name | MS. JUDITH A. TISCHER
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Credential | LMFC
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Telephone | 530-661-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC33208
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License Number State | CA
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