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Organization
NORTHERN CALIFORNIA ABUSE TREATMENT
Active
Organization
NORTHERN CALIFORNIA ABUSE TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY JEAN ELLIS LMFT (CLINICAL DIRECTOR)
(530) 477-7016
Entity
Organization
Contact information
Practice address
2059 NEVADA CITY HWY STE 104, GRASS VALLEY, CA 95945-7708
(530) 477-7016
(530) 477-5919
Mailing address
2036 NEVADA CITY HWY # 237, GRASS VALLEY, CA 95945-7700
(530) 477-7016
(530) 477-5919
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
IMF 49385
CA
106H00000X
Marriage & Family Therapist
Primary
MFC 22869
CA
106H00000X
Marriage & Family Therapist
MFC 41740
CA
106H00000X
Marriage & Family Therapist
MFC 42832
CA
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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