Provider Demographics
NPI:1689336901
Name:ADVANCED BEHAVIORAL HEALTH CARE OF THE CENTRAL COAST
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH CARE OF THE CENTRAL COAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-720-2536
Mailing Address - Street 1:155 S FIRST ST # 2914
Mailing Address - Street 2:
Mailing Address - City:ORCUTT
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5298
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5802 FOXGLOVE CT
Practice Address - Street 2:
Practice Address - City:ORCUTT
Practice Address - State:CA
Practice Address - Zip Code:93455-2887
Practice Address - Country:US
Practice Address - Phone:805-720-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty