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900 E. Hamilton Ave, Suite 100 Campbell CA 95008 | |
| (408) 384-8404 | |
| (408) 608-0484 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 900 E. Hamilton Ave,, Campbell, California |
| Authorized Official Name and Position | Laura Lc Johnson (CENTER DIRECTOR/OWNER) |
| Authorized Official Contact | 4083848404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
900 E. Hamilton Ave, Suite 100 Campbell CA 95008 Ph: (408) 384-8404 | 900 E. Hamilton Ave, Suite 100 Campbell CA 95008 Ph: (408) 384-8404 |
| NPI Number | 1376815829 |
|---|---|
| Provider Enumeration Date | 01/30/2012 |
| Last Update Date | 08/18/2020 |
| Certification Date | 08/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376815829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC-48807 (California) | Primary |
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