Provider Demographics
NPI:1831323682
Name:FAMILY CENTER FOR SEXUAL ABUSE PREVENTION AND THERAPY
Entity Type:Organization
Organization Name:FAMILY CENTER FOR SEXUAL ABUSE PREVENTION AND THERAPY
Other - Org Name:PASOS FIRMES
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:ROSALES-WYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-832-2574
Mailing Address - Street 1:1904 FRANKLIN ST
Mailing Address - Street 2:SUITE 703
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2912
Mailing Address - Country:US
Mailing Address - Phone:510-832-2574
Mailing Address - Fax:510-832-2562
Practice Address - Street 1:1904 FRANKLIN ST
Practice Address - Street 2:SUITE 703
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2912
Practice Address - Country:US
Practice Address - Phone:510-832-2574
Practice Address - Fax:510-832-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 228151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty