Provider Demographics
NPI:1083748305
Name:TOOTELL, ERIK (MFT, PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:TOOTELL
Suffix:
Gender:M
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CALIFORNIA ST.
Mailing Address - Street 2:#18
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2958
Mailing Address - Country:US
Mailing Address - Phone:530-848-1544
Mailing Address - Fax:
Practice Address - Street 1:285 COURT ST.
Practice Address - Street 2:STE. 202
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2077
Practice Address - Country:US
Practice Address - Phone:530-848-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 30975101YM0800X
CA21367103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health