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General NPI Number Information
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NPI Number | 1265102263
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Entity Type | Organization
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Legal Business Name | HANNA BOYS CENTER
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 17000 ARNOLD DR
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City | SONOMA
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State | CA
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Zip | 95476-3242
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Country | US
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Telephone | 707-996-6767
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Fax | 707-996-4795
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Provider Business Mailing Address
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Address Line | 17000 ARNOLD DR
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City | SONOMA
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State | CA
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Zip | 95476-3242
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Country | US
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Telephone | 707-996-6767
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Fax | 707-996-4795
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | NOELI CARDENAS ZAMORA
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Credential | LMFT
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Telephone | 707-996-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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Taxonomy #4
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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Taxonomy #5
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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Taxonomy #6
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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Taxonomy #7
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #9
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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Taxonomy #10
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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Taxonomy #11
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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Taxonomy #12
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #13
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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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