Provider Demographics
NPI:1609687995
Name:SHIFTING SEASONS THERAPY CORPORATION
Entity type:Organization
Organization Name:SHIFTING SEASONS THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-689-0765
Mailing Address - Street 1:PO BOX 280576
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91328-0576
Mailing Address - Country:US
Mailing Address - Phone:818-689-0765
Mailing Address - Fax:
Practice Address - Street 1:18402 HALSTED ST APT 31
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4903
Practice Address - Country:US
Practice Address - Phone:818-689-0765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty