Provider Demographics
NPI:1023356102
Name:INFANT PARENT CENTER
Entity type:Organization
Organization Name:INFANT PARENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:KALSBEEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-676-2899
Mailing Address - Street 1:3430 ROBIN LN STE 4
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8441
Mailing Address - Country:US
Mailing Address - Phone:530-676-2899
Mailing Address - Fax:530-387-6456
Practice Address - Street 1:3430 ROBIN LN STE 4
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8441
Practice Address - Country:US
Practice Address - Phone:530-676-2899
Practice Address - Fax:530-387-6456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46646106H00000X
CA48763106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty