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General NPI Number Information
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NPI Number | 1942650239
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Entity Type | Organization
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Legal Business Name | GRATEFUL HEART HOLISTIC THERAPY CENTER
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 360 GRAND AVE #46
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City | OAKLAND
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State | CA
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Zip | 94610-4840
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Country | US
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Telephone | 510-394-5065
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Fax |
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Provider Business Mailing Address
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Address Line | 360 GRAND AVE #46
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City | OAKLAND
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State | CA
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Zip | 94610-4840
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Country | US
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Telephone | 510-394-5065
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | RAWNA CHERI ROMERO
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Credential | LMFT
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Telephone | 415-533-9724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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