Organization
ANN STRACK, PH.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE STRACK (OWNER)
(707) 762-6216
Entity
Organization
Contact information
Practice address
318 WESTERN AVE, PETALUMA, CA 94952-2919
(707) 762-6216
Mailing address
318 WESTERN AVE, PETALUMA, CA 94952-2919
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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