Provider Demographics
NPI:1154904704
Name:TRANSFORMATIONAL FAMILY COUNSELING PC
Entity type:Organization
Organization Name:TRANSFORMATIONAL FAMILY COUNSELING PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED MFT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LMFT
Authorized Official - Phone:951-934-8944
Mailing Address - Street 1:3400 CENTRAL AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2176
Mailing Address - Country:US
Mailing Address - Phone:951-934-8944
Mailing Address - Fax:951-346-9583
Practice Address - Street 1:3400 CENTRAL AVE STE 215
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2175
Practice Address - Country:US
Practice Address - Phone:951-934-8944
Practice Address - Fax:951-346-9583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-02
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty