# WILD GOOSE MARRIAGE AND FAMILY THERAPY, A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023962461
- **Authorized official:** MS. MARTI ELIZABETH FAYE TOURVILLE LMFT (PRESIDENT)
- **Authorized official phone:** (530) 588-0035

## Contact information

- **Practice address:** 574 MANZANITA AVE STE 8, CHICO, CA 95926-1369
- **Practice address phone:** (530) 570-2453
- **Mailing address:** 550 VALLOMBROSA AVE, P.O. BOX 2323, CHICO, CA 95926
- **Mailing address phone:** (530) 570-2453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2026
- **Last updated:** 02/23/2026