Provider Demographics
NPI:1134437148
Name:DISCOVERY PSYCHOTHERAPY CENTER, INC.
Entity type:Organization
Organization Name:DISCOVERY PSYCHOTHERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:530-676-4445
Mailing Address - Street 1:4120 CAMERON PARK DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8480
Mailing Address - Country:US
Mailing Address - Phone:530-676-4445
Mailing Address - Fax:
Practice Address - Street 1:4120 CAMERON PARK DR
Practice Address - Street 2:SUITE 301
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8480
Practice Address - Country:US
Practice Address - Phone:530-676-4445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty