Wild Sage Family Therapy Center Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

WILD SAGE FAMILY THERAPY CENTER INC

Practice address

190 Sierra CT Ste A322
Palmdale, CA 93550-7607

Phone

(661) 220-9226

Fax

(661) 208-3998

NPI assigned

Aug 16, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robelle Church, LMFTNPI 1649693763

Title

Owner

Phone

(661) 220-9226

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robelle Church

  • Marriage & Family Therapist
  • Lancaster, CA
  • NPI 1649693763
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1003534058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SIERRA CT STE A322",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507607",
            "telephone_number": "661-220-9226",
            "fax_number": "661-208-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SIERRA CT STE A322",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507607",
            "telephone_number": "661-220-9226",
            "fax_number": "661-208-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD SAGE FAMILY THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "ROBELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-220-9226",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreanna Danielle Whitaker
• Ernie White
• Joey Benard Whiting Sr.
• Whole Life Pathways
• Ushani Wijesundara
• Ike Wilder
• William H. Davis Treatment Center
• William S Brawders OD a PC
• Aisha Michelle Williams
• Amanda Cheryl Williams, RADT

• Marriage & Family Therapist in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.