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General NPI Number Information
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NPI Number | 1508439720
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Entity Type | Organization
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Legal Business Name | CULTURAL CONNECTION THERAPY CENTER
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Dates
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Enumeration Date | 07/24/2021
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 719 2ND ST STE 8
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City | DAVIS
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State | CA
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Zip | 95616-4666
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Country | US
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Telephone | 530-505-1994
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Fax | 530-231-0128
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Provider Business Mailing Address
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Address Line | 719 2ND ST STE 8
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City | DAVIS
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State | CA
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Zip | 95616-4666
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Country | US
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Telephone | 530-505-1994
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Fax | 530-231-0128
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Authorized Official
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Title or Position | OWNER
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Name | MARIANA NOGUEIRA
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Credential | LCSW
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Telephone | 408-416-1710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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