Provider Demographics
NPI:1831550227
Name:CHICO CENTER FOR COGNITIVE BEHAVIOR THERAPY
Entity type:Organization
Organization Name:CHICO CENTER FOR COGNITIVE BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MINDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:530-690-5635
Mailing Address - Street 1:341 BROADWAY ST
Mailing Address - Street 2:STE 414
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-5342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:341 BROADWAY ST
Practice Address - Street 2:STE 414
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-5342
Practice Address - Country:US
Practice Address - Phone:530-690-5635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & SportsGroup - Single Specialty