Provider Demographics
NPI:1619290467
Name:HOPE; HEALTHY OUTCOMES FOR PERSONAL ENRICHMENT COUNSELING CENTER
Entity Type:Organization
Organization Name:HOPE; HEALTHY OUTCOMES FOR PERSONAL ENRICHMENT COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-248-2436
Mailing Address - Street 1:2540 DOUGLAS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3946
Mailing Address - Country:US
Mailing Address - Phone:916-780-1059
Mailing Address - Fax:916-780-1058
Practice Address - Street 1:2540 DOUGLAS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3946
Practice Address - Country:US
Practice Address - Phone:916-780-1059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40875251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health