Provider Demographics
NPI:1790038560
Name:CALIFORNIA PARENTING INSTITUTE
Entity Type:Organization
Organization Name:CALIFORNIA PARENTING INSTITUTE
Other - Org Name:CPI CHILDREN'S COUNSELING CENTER-NEW DIRECTIONS CAMPUS
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIPOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-585-6108
Mailing Address - Street 1:3650 STANDISH AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407
Mailing Address - Country:US
Mailing Address - Phone:707-585-6108
Mailing Address - Fax:707-585-2158
Practice Address - Street 1:3641 STONY POINT RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407
Practice Address - Country:US
Practice Address - Phone:707-585-3700
Practice Address - Fax:707-585-3883
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CPI CHILDREN'S COUNSELING CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-18
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22027103T00000X
CALSC22463104100000X
CAMFC45574106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty