Provider Demographics
NPI:1689056442
Name:SPRING TO AUTUMN FAMILY THERAPY
Entity Type:Organization
Organization Name:SPRING TO AUTUMN FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MFT
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WETHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:909-557-6574
Mailing Address - Street 1:PO BOX 7461
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-0461
Mailing Address - Country:US
Mailing Address - Phone:909-557-6574
Mailing Address - Fax:909-363-9202
Practice Address - Street 1:2068 ORANGE TREE LN STE 216
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4555
Practice Address - Country:US
Practice Address - Phone:909-557-6574
Practice Address - Fax:909-363-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79300106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty