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General NPI Number Information
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NPI Number | 1407501240
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Entity Type | Organization
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Legal Business Name | RADICAL HOPE CENTER FOR PSYCHOTHERAPY, A CLINICAL PSYCHOLOGY AND LICEN
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 1508 F ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-1609
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Country | US
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Telephone | 973-902-9823
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Fax |
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Provider Business Mailing Address
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Address Line | 8735 SUMMER SUN WAY
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City | ELK GROVE
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State | CA
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Zip | 95624-1297
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Country | US
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Telephone | 973-902-9823
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA NAUGHTON
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Credential | LCSW
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Telephone | 973-902-9823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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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License Number State |
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