West Coast Posttrauma Retreat

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

PSY 18339 Issued in CA

Legal business name

WEST COAST POSTTRAUMA RETREAT

Practice address

4460 - 16 Redwood Hwy
Suite 362
San Rafael, CA 94903-1953

Phone

(415) 721-9789

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Joel Fay, PSY.D.

Title

President

Phone

(415) 720-6653

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891728267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 - 16 REDWOOD HWY",
            "address_2": "SUITE 362",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031953",
            "telephone_number": "415-721-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 - 16 REDWOOD HWY",
            "address_2": "SUITE 362",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031953",
            "telephone_number": "415-721-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST POSTTRAUMA RETREAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAY",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-720-6653",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "CA",
            "license": "PSY 18339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Edward Welter, M.D.
• Hui-Shan A. Wen, DO
• Lauren Foley Wenderoth, RD
• Gina Wermuth, M.A., CCC-SLP
• West Bay Urgent Care Associates Inc a Medical Corporation
• Donna West, PHN
• Stacy West
• Westco Fiji Care LLC
• Judith Weston-Thompson, MFT
• Westwood & Streeterville Associates, LLC

• Psychiatric Residential Treatment Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Psychiatric Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.