Organization
SOMA PSYCH FAMILY THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTENA RACHEL WILSON (CHIEF EXECUTIVE OFFICER (CEO))
(760) 459-9790
Entity
Organization
Contact information
Practice address
2021 SPERRY AVE STE 20, VENTURA, CA 93003-7446
(760) 459-9790
Mailing address
85 PONIU CIR, WAILUKU, HI 96793-2906
(760) 459-9790
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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