Organization
CHILD THERAPY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN LUKAS PHD (EXECUTIVE DIRECTOR)
(415) 456-7724
Entity
Organization
Contact information
Practice address
1501 WASHINGTON AVE, ALBANY, CA 94706-1856
(510) 525-6225
Mailing address
1480 LINCOLN AVE STE 8, SAN RAFAEL, CA 94901-2085
(415) 456-7724
(415) 456-1050
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
03/15/2007
Last updated
12/20/2018
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