Organization
CENTER FOR INTEGRATIVE PSYCHOLOGY & WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORIE T DECARVALHO PH.D., BCETS, FNCCM (FOUNDER AND PRESIDENT/CEO)
(707) 253-9115
Entity
Organization
Contact information
Practice address
1040 MAIN ST, #305, NAPA, CA 94559-2654
(559) 253-9115
Mailing address
PO BOX 1932, HANFORD, CA 93232-1932
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY20053
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366480915
—
CA
Enumeration date
12/24/2010
Last updated
03/30/2011
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