| Organization Name: | PSYCHOTHERAPY INSTITUTE OF INDIVIDUAL, FAMILY & COMMUNITY DEVELOPMENT |
| NPI Number: | 1063565745 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WESLEY A ROBINSON (VICE PRESIDENT) |
| Mailing Address: | 509 W 10th St Antioch |
| State: | CA US |
| Postal Code: | 945091653 |
| Phone Number: | 9257779540 |
| Fax Number: | 9257579024 |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY15066 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |