=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790176642
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPYWORKS & ASSOCIATES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2015
-----------------------------------------------------
Last Update Date | 02/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 334 VILLAGE LN
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95030-7218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-508-6789
-----------------------------------------------------
Fax | 408-399-8909
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 334 VILLAGE LN
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95030-7218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER AND PRESIDENT
-----------------------------------------------------
Name | MAALIEA WILBUR
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 408-508-6789
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 50997
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------