Family Tree Psychology Group Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FAMILY TREE PSYCHOLOGY GROUP INC.

Doing business as

Family Tree Wellness Center

Practice address

3655 Grand Ave
Oakland, CA 94610-2009

Phone

(510) 858-7649

NPI assigned

Sep 1, 2020

Organization subpart

No

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

Authorized official

Name

Carmelinda M Mann, PHDNPI 1326216235

Title

Ceo

Phone

(415) 515-6234

Specialties & licenses 3

Addresses

Other names 1

• Family Tree Wellness Center Doing business as

Locations

Practitioners 1

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

• Carmelinda Martin Mann, PH.D.

  • Clinical Psychologist
  • Oakland, CA
  • NPI 1326216235
  NPD Authorized official

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1619581337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102009",
            "telephone_number": "510-858-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102009",
            "telephone_number": "510-858-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY TREE PSYCHOLOGY GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "CARMELINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-515-6234",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Tree Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Calvin Fammons
• Akinjide Famoyegun
• Grace Y. Fan, MD
• Horng D Fan, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Oakland, CA
• Providers in Oakland, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.