Organization
CAMPBELL TEEN & FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID T HIGGINS MA (OWNER)
(408) 579-9806
Entity
Organization
Contact information
Practice address
441 N CENTRAL AVE STE 6, CAMPBELL, CA 95008-1428
(408) 579-9806
Mailing address
441 N CENTRAL AVE STE 6, CAMPBELL, CA 95008-1428
(408) 579-9806
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508080953
NPI
CA
Enumeration date
11/07/2019
Last updated
11/07/2019
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