Provider Demographics
NPI:1649011008
Name:YELLOW ROSE FAMILY THERAPY
Entity type:Organization
Organization Name:YELLOW ROSE FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-952-3223
Mailing Address - Street 1:4515 CAYUCOS AVE
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-2707
Mailing Address - Country:US
Mailing Address - Phone:805-952-3223
Mailing Address - Fax:805-703-5539
Practice Address - Street 1:4555 EL CAMINO REAL STE J
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-2700
Practice Address - Country:US
Practice Address - Phone:805-952-3223
Practice Address - Fax:805-703-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-01
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty