Provider Demographics
NPI:1871734228
Name:VINEWOOD CENTER FOR CHILDREN AND FAMILIES
Entity type:Organization
Organization Name:VINEWOOD CENTER FOR CHILDREN AND FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NORDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-835-8282
Mailing Address - Street 1:35 E. 10TH STREET SUITE J1
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376
Mailing Address - Country:US
Mailing Address - Phone:209-835-8282
Mailing Address - Fax:209-835-8133
Practice Address - Street 1:35 E 10TH ST STE J1
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4070
Practice Address - Country:US
Practice Address - Phone:209-835-8282
Practice Address - Fax:209-835-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable