Provider Demographics
NPI:1891293734
Name:SPIRAL PROCESS THERAPY
Entity Type:Organization
Organization Name:SPIRAL PROCESS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VULFOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-737-1498
Mailing Address - Street 1:815 W SAN FERNANDO ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-4815
Mailing Address - Country:US
Mailing Address - Phone:718-737-1498
Mailing Address - Fax:
Practice Address - Street 1:815 W SAN FERNANDO ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-4815
Practice Address - Country:US
Practice Address - Phone:718-737-1498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty