| Root Psychotherapy | |
|
5082 Dupont Drive Santa Rosa CA 95409 | |
| (224) 386-6832 | |
| Not Available |
| Full Name | Root Psychotherapy |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5082 Dupont Drive, Santa Rosa, California |
| Authorized Official Name and Position | Keri Gnanashanmugam (PRACTICE OWNER) |
| Authorized Official Contact | 8325401630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Root Psychotherapy 1275 4th St # 5002 Santa Rosa CA 95404-4057 Ph: () - | Root Psychotherapy 5082 Dupont Drive Santa Rosa CA 95409 Ph: (224) 386-6832 |
| NPI Number | 1235964636 |
|---|---|
| Provider Enumeration Date | 09/05/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235964636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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