| Lifeworks | |
|
1700 Fulton Rd Santa Rosa CA 95403-1815 | |
| (707) 568-2300 | |
| (707) 568-2304 |
| Full Name | Lifeworks |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1700 Fulton Rd, Santa Rosa, California |
| Authorized Official Name and Position | Michael K Tonjum (DIRECTOR) |
| Authorized Official Contact | 7075682300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeworks 1200 College Ave Santa Rosa CA 95404-3908 Ph: (707) 568-2300 | Lifeworks 1700 Fulton Rd Santa Rosa CA 95403-1815 Ph: (707) 568-2300 |
| NPI Number | 1740490176 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740490176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY13055 (California) | Primary |
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