THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS (NPI# 1396134615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396134615 |
| Entity Type | Organization |
| Organization Name | THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS |
| Practice Address |
1626 Fourth Street Santa Rosa CA 95404 |
| Practice Telephone | 7075955637 |
| Practice Fax Number | 7075955637 |
| Mailing Telephone | 7075955637 |
| Mailing Fax Number | 7075955637 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |
| Authorized Official Name | MR. RICHARD A. SELCKE (FOUNDER, CLINICAL DIRECTOR) |
| Authorized Official Telephone | 7075955637 |
| Authorized Official Credential | M.F.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
1626 FOURTH STREET |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1427451855 | Amanda Dunn | Registered Nurse | 1337 Chanate Road Suite 2c, Santa Rosa, CA 95404 | 2014-09-30 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093220675 | County of Sonoma | Clinic/Center | 7400 Rancho Los Guilicos Rd, Santa Rosa, CA 95409-6540 | 2017-12-05 |
| 1770924326 | Bartlett Chiropractic, Inc | Clinic/Center | 2718 Tachevah Dr, Santa Rosa, CA 95405-8420 | 2013-07-11 |
| 1962613349 | Santa Rosa Community Health Centers | Clinic/Center | 3569 Round Barn Circle, Santa Rosa, CA 95403-5781 | 2007-05-25 |
| 1205980547 | Department of Health Services | Clinic/Center | 415 Riley Street, Santa Rosa, CA 95404 | 2007-01-23 |
| 1114071453 | Department of Health Services | Clinic/Center | 155 N. Pythian Road, Santa Rosa, CA 95409 | 2007-01-23 |
| 1316439979 | Women's Obgyn | Clinic/Center | 1111 Sonoma Avenue, Suite 202, Santa Rosa, CA 95405 | 2018-05-30 |
| 1265949259 | County of Sonoma | Clinic/Center | 2245 Challenger Way Ste 100, Santa Rosa, CA 95407-5418 | 2017-12-29 |
| 1003225061 | Elyse R. Eisenberg, Md, Inc. | Clinic/Center | 725 Farmers Ln, Ste 10, Santa Rosa, CA 95405-6710 | 2014-08-04 |
| 1053662353 | Thomas M. Collins Chiropractic, Inc. | Clinic/Center | 1212 Farmers Ln, Suite 2, Santa Rosa, CA 95405-6747 | 2012-09-26 |
| 1124305495 | Sonoma County Indian Health Project Inc. | Clinic/Center | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2011-11-14 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
Please comment or provide details below to improve the information on THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS.
| 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.