Provider Demographics
NPI:1942924899
Name:SONOMA THERAPEUTIC ARTS AND EDUCATION, A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:SONOMA THERAPEUTIC ARTS AND EDUCATION, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CAROLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-763-1091
Mailing Address - Street 1:7 4TH ST STE 64
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-7410
Mailing Address - Country:US
Mailing Address - Phone:707-763-1091
Mailing Address - Fax:
Practice Address - Street 1:7 4TH ST
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3043
Practice Address - Country:US
Practice Address - Phone:707-763-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty