Provider Demographics
NPI:1669590451
Name:CALIFORNIA PARENTING INSTITUTE
Entity type:Organization
Organization Name:CALIFORNIA PARENTING INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY, D
Authorized Official - Phone:707-585-6108
Mailing Address - Street 1:3650 STANDISH AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-8113
Mailing Address - Country:US
Mailing Address - Phone:707-585-6108
Mailing Address - Fax:707-585-2158
Practice Address - Street 1:3650 STANDISH AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407
Practice Address - Country:US
Practice Address - Phone:707-585-6108
Practice Address - Fax:707-585-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health