Organization
FAMILY DYNAMICS RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA ANN WILSON MA, LMFT (EXECUTIVE DIRECTOR)
(530) 605-9902
Entity
Organization
Contact information
Practice address
3657 RICARDO AVE, REDDING, CA 96002-2627
(530) 242-9007
Mailing address
3657 RICARDO AVE, REDDING, CA 96002-2627
(530) 242-9007
(530) 223-2027
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
49910
CA
251S00000X
Community/Behavioral Health Agency
LCS22115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023168259
1 INDIVIDUAL
CA
01
—
1619272564
FAMILY DYNAMICS RESOURCE CENTER
CA
01
—
1942221130
1-INDIVIDUAL
CA
Enumeration date
01/24/2011
Last updated
08/06/2013
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