# DEEP WELLNESS CENTER CHILD & FAMILY INC

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

## Provider details

- **NPI number:** 1760865794
- **Authorized official:** RAMANDEEP DHALIWAL M.S. LMFT (MARRIAGE & FAMILY THERAPIST)
- **Authorized official phone:** (209) 665-6857

## Contact information

- **Practice address:** 5815 STODDARD RD STE 600, MODESTO, CA 95356-9041
- **Practice address phone:** (209) 665-6857
- **Mailing address:** 5815 STODDARD RD STE 600, MODESTO, CA 95356-9041
- **Mailing address phone:** (209) 665-6857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | CA | — |
| 101YM0800X | Mental Health Counselor | — | CA | — |
| 103TC0700X | Clinical Psychologist | — | CA | — |
| 1041C0700X | Clinical Social Worker | — | CA | — |
| 106H00000X | Marriage & Family Therapist | LMFT 52611 | CA | Yes |

## Other

- **Enumeration date:** 07/08/2015
- **Last updated:** 07/08/2015