Provider Demographics
NPI:1568764306
Name:TRI-VALLEY BEHAVIORAL HEALTH RESOURCES INC.
Entity Type:Organization
Organization Name:TRI-VALLEY BEHAVIORAL HEALTH RESOURCES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:661-388-8212
Mailing Address - Street 1:22306 CYPRESS PL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91390-4088
Mailing Address - Country:US
Mailing Address - Phone:661-388-8212
Mailing Address - Fax:661-244-0015
Practice Address - Street 1:22306 CYPRESS PLACE
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91390-4088
Practice Address - Country:US
Practice Address - Phone:661-388-8212
Practice Address - Fax:661-244-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23711103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFG521AMedicare UPIN