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Organization
CHILD & INDIVIDUAL ART THERAPY
Active
Organization
CHILD & INDIVIDUAL ART THERAPY
Active
Other names
Kavanaugh Therapy, Inc., NQ Therapy, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ORTEGA ORTEGA (BILLING & OPERATIONS MANAGER)
(530) 316-4248
Entity
Organization
Contact information
Practice address
2401 PACIFIC COAST HWY STE 106, HERMOSA BEACH, CA 90254-2734
(424) 247-6010
Mailing address
PO BOX 19, PORTOLA, CA 96122-0019
(530) 316-4248
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
221700000X
Art Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
07/22/2026
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