Basic Information
| Provider Information | |||||||||
| NPI: | 1639576002 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALDEA CHILDREN AND FAMILY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1546 1ST ST | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945592841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072530123 | ||||||||
| FaxNumber: | 7072538118 | ||||||||
| Practice Location | |||||||||
| Address1: | 1546 FIRST STREET | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 64559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072530123 | ||||||||
| FaxNumber: | 7072538118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2014 | ||||||||
| LastUpdateDate: | 12/01/2014 | ||||||||
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| AuthorizedOfficialLastName: | MONTES | ||||||||
| AuthorizedOfficialFirstName: | DIANA | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | BILINGUAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 7867522558 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MFTI | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 78516 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.