Provider Demographics
NPI:1164126710
Name:HEALING ROOTS FAMILY THERAPY, INC.
Entity Type:Organization
Organization Name:HEALING ROOTS FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRISHUHN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-586-6961
Mailing Address - Street 1:312 5TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1058
Mailing Address - Country:US
Mailing Address - Phone:559-586-6961
Mailing Address - Fax:
Practice Address - Street 1:312 5TH ST STE A
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1058
Practice Address - Country:US
Practice Address - Phone:559-586-6961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)