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General NPI Number Information
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NPI Number | 1316495427
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Entity Type | Organization
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Legal Business Name | CENTRAL SIERRA COUNSELING CENTER
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Dates
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Enumeration Date | 09/17/2016
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 950 S WASHINGTON ST
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City | SONORA
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State | CA
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Zip | 95370
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Country | US
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Telephone | 209-536-4874
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Fax | 209-536-4232
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Provider Business Mailing Address
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Address Line | PO BOX 4162
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City | SONORA
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State | CA
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Zip | 95370-4162
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Country | US
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Telephone | 209-536-4874
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Fax | 209-536-4874
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Authorized Official
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Title or Position | DIRECTOR
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Name | WILLIAM SILVA
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Credential | M.A.
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Telephone | 209-536-4874
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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 | 39977
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License Number State | CA
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