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Organization
EMBODIED ECOLOGY GROUP
Active
Organization
EMBODIED ECOLOGY GROUP
Active
Other names
The Center, Santa Cruz Neurofeedback Center
Organization subpart
No
Provider details
NPI number
Authorized official
LANGDON SE ROBERTS (CEO)
(831) 239-6353
Entity
Organization
Contact information
Practice address
2425 PORTER ST STE 7, SOQUEL, CA 95073-2454
(831) 464-1419
(831) 476-7529
Mailing address
2425 PORTER ST STE 7, SOQUEL, CA 95073-2454
(831) 464-1419
(831) 476-7529
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
80304
CA
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
172M00000X
Mechanotherapist
50028
CA
174H00000X
Health Educator
—
NULL
174H00000X
Health Educator
—
—
Other
Enumeration date
05/11/2017
Last updated
12/11/2020
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