Provider Demographics
NPI:1982158101
Name:POSITIVE SELF
Entity Type:Organization
Organization Name:POSITIVE SELF
Other - Org Name:POSITIVE SELF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMEIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-936-2497
Mailing Address - Street 1:204 N FLORAL ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4957
Mailing Address - Country:US
Mailing Address - Phone:559-936-2497
Mailing Address - Fax:559-553-8872
Practice Address - Street 1:204 N FLORAL ST
Practice Address - Street 2:SUITE F
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4957
Practice Address - Country:US
Practice Address - Phone:559-936-2497
Practice Address - Fax:559-553-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA217201041C0700X
CA41331106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty