CHILD THERAPY INSTITUTE OF MARIN (NPI# 1497935308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497935308 |
| Entity Type | Organization |
| Organization Name | CHILD THERAPY INSTITUTE OF MARIN |
| Practice Address |
2926 Lone Tree Way Antioch CA 94509-4924 |
| Mailing Address |
1480 Lincoln Ave Ste 8 San Rafael CA 94901-2085 |
| Practice Telephone | 9253017587 |
| Mailing Telephone | 4154567724 |
| Mailing Fax Number | 4154561050 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |
| Authorized Official Name | BRIAN LUKAS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4154567727 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073074324 | Child Therapy Institute of Marin | Community/Behavioral Health | 3195 California St Ste D, San Francisco, CA 94115-2412 | 2019-03-28 |
| 1760891931 | Child Therapy Institute of Marin | Clinic/Center | 2300 Martin Luther King Jr Way, Resource Room, Berkeley, CA 94704-1412 | 2014-08-12 |
| 1487092144 | Child Therapy Institute of Marin | Community/Behavioral Health | 2015 Virginia St, Berkeley, CA 94709-2229 | 2013-06-04 |
| 1265790489 | Child Therapy Institute of Marin | Community/Behavioral Health | 92 Louise Street, San Rafael, CA 94901 | 2012-04-25 |
| 1619014081 | Child Therapy Institute of Marin | Clinic/Center | 1480 Lincoln Ave Ste 8, San Rafael, CA 94901-2085 | 2007-02-01 |
| 1821633348 | Child Therapy Institute of Marin | Marriage & Family Therapist | 558 San Anselmo Ave, San Anselmo, CA 94960-2621 | 2019-11-07 |
| 1134641731 | Child Therapy Institute of Marin | Clinic/Center | 11100 San Pablo Ave Ste 205, El Cerrito, CA 94530-2100 | 2017-07-14 |
| 1790216489 | Child Therapy Institute of Marin | Community/Behavioral Health | 240 Tamal Vista Blvd, #155, Corte Madera, CA 94925-1132 | 2017-03-23 |
| 1801256300 | Child Therapy Institute of Marin | Community/Behavioral Health | 700 E St, San Rafael, CA 94901-2762 | 2016-02-26 |
| 1154713774 | Child Therapy Institute of Marin | Clinic/Center | 720 Southpoint Blvd, Petaluma, CA 94954-7495 | 2015-02-19 |
| Street Address |
2926 LONE TREE WAY |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-4924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922155530 | Clair L. Howard | Psychologist | 2926 Lone Tree Way, Antioch, CA 94509-4924 | 2007-01-04 |
| 1780735472 | Evelyne Teehankee Zulueta | Marriage & Family Therapist | 2926 Lone Tree Way, Antioch, CA 94509-4924 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824046 | Lincoln | Community/Behavioral Health | 1708 F St, Antioch, CA 94509-2225 | 2019-07-25 |
| 1326503079 | Pcs Mental Health LLC | Community/Behavioral Health | 2031 Antioch Pike Ste 101, Antioch, TN 37013-3315 | 2019-02-07 |
| 1356810188 | Medical One, LLC | Community/Behavioral Health | 2213 Buchanan Rd Ste 202, Antioch, CA 94509-4265 | 2018-11-22 |
| 1962983262 | Lincoln | Community/Behavioral Health | 2304 G St, Antioch, CA 94509-3500 | 2018-08-24 |
| 1518448810 | Lincoln | Community/Behavioral Health | 615 Greystone Dr, Antioch, CA 94509-6990 | 2018-08-24 |
| 1609357904 | Lincoln | Community/Behavioral Health | 1931 Mokelumne Dr, Antioch, CA 94531-9129 | 2018-08-24 |
| 1053892356 | Lincoln | Community/Behavioral Health | 2801 Roosevelt Ln, Antioch, CA 94509-5038 | 2018-08-24 |
| 1700367166 | Lincoln | Community/Behavioral Health | 4721 Vista Grande Dr, Antioch, CA 94531-8619 | 2018-08-23 |
| 1407272941 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 512 E St Unit B, Antioch, CA 94509 | 2014-03-07 |
| 1578848560 | La Cheim School Inc. | Community/Behavioral Health | 1413 F Street, Antioch, CA 94509-2220 | 2011-10-21 |
| Find all providers in ANTIOCH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.