Provider Demographics
NPI:1922710029
Name:SACRED TREE THERAPY INC
Entity Type:Organization
Organization Name:SACRED TREE THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZORA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:619-333-6574
Mailing Address - Street 1:411 S MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-5212
Mailing Address - Country:US
Mailing Address - Phone:619-938-4108
Mailing Address - Fax:619-332-2690
Practice Address - Street 1:411 S MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5212
Practice Address - Country:US
Practice Address - Phone:619-333-6574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty