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Organization
TAIRA ST. JOHN
Active
Organization
TAIRA ST. JOHN
Active
Other names
Clear Lake Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAIRA ST. JOHN PH.D., M.F.T. (CLINICAL DIRECTOR)
(707) 262-0400
Entity
Organization
Contact information
Practice address
149 N MAIN ST, SUITE 210, LAKEPORT, CA 95453-4832
(707) 262-0400
(707) 262-0340
Mailing address
PO BOX 716, LAKEPORT, CA 95453-0716
(707) 262-0400
(707) 262-0340
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/31/2010
Last updated
03/31/2010
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