Provider Demographics
NPI:1477188589
Name:SILVER FERN CHILD & FAMILY THERAPY INCORPORATED
Entity Type:Organization
Organization Name:SILVER FERN CHILD & FAMILY THERAPY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROPPETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-269-4468
Mailing Address - Street 1:3075 CITRUS CIR STE 165
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:925-553-5090
Practice Address - Street 1:3075 CITRUS CIR STE 165
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2669
Practice Address - Country:US
Practice Address - Phone:925-553-3376
Practice Address - Fax:925-553-5090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty