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Organization
SOMA PSYCH FOUNDATION CENTER INC
Active
Organization
SOMA PSYCH FOUNDATION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTENA WILSON LMFT (CEO)
(760) 459-9790
Entity
Organization
Contact information
Practice address
2021 SPERRY AVE STE 20, VENTURA, CA 93003-7446
(760) 459-9790
Mailing address
2021 SPERRY AVE STE 20, VENTURA, CA 93003-7446
(760) 459-9790
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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