| Organization Name: | REDWOOD PSYCHOLOGY CENTER, INC |
| NPI Number: | 1629196290 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTONIO MADRID (EXECUTIVE DIRECTOR) |
| Mailing Address: | 16320 1st St Unit 14 A Guerneville |
| State: | CA US |
| Postal Code: | 95446 |
| Phone Number: | 7078651200 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 12/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TP2701X |
| License Number: | 110000330 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Group Psychotherapy |
| Taxonomy Definition: | |