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General NPI Number Information
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NPI Number | 1255791513
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Entity Type | Organization
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Legal Business Name | HUMANISTIC PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 831 ALAMO DR STE 6B
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City | VACAVILLE
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State | CA
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Zip | 95688-5343
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Country | US
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Telephone | 858-449-6301
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5235
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City | VACAVILLE
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State | CA
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Zip | 95696-5235
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Country | US
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Telephone | 858-449-6301
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MICHAEL HENRY
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Credential | PHD
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Telephone | 858-449-6301
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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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