Provider Demographics
NPI:1366173783
Name:ATARAXY LLC
Entity type:Organization
Organization Name:ATARAXY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:THAO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-679-3110
Mailing Address - Street 1:3345 BIXLER RD UNIT 1308
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-5020
Mailing Address - Country:US
Mailing Address - Phone:510-679-3110
Mailing Address - Fax:
Practice Address - Street 1:3345 BIXLER RD UNIT 1308
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505-5020
Practice Address - Country:US
Practice Address - Phone:510-679-3110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty