Basic Information
| Provider Information | |||||||||
| NPI: | 1033574462 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRANSITIONS MENTAL HEALTH ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 15408 | ||||||||
| Address2: | |||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934065408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055406500 | ||||||||
| FaxNumber: | 8055406501 | ||||||||
| Practice Location | |||||||||
| Address1: | 1977 SANTA BARBARA AVENUE, SUITE 101 | ||||||||
| Address2: | |||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934015235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055482644 | ||||||||
| FaxNumber: | 8055406501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2015 | ||||||||
| LastUpdateDate: | 02/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | ENGLERT | ||||||||
| AuthorizedOfficialFirstName: | MEGHAN | ||||||||
| AuthorizedOfficialMiddleName: | GENE | ||||||||
| AuthorizedOfficialTitleorPosition: | QUALITY ASSURANCE | ||||||||
| AuthorizedOfficialTelephone: | 8055406532 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LMFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | CA | N | Agencies | Community/Behavioral Health | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.