Wakefield, Phylis Jane

Wakefield, Phylis Jane is an sole proprietor health care provider with primary practice located at 1151 Broadway Suite 202, Sonoma CA 95476-7571. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Wakefield, Phylis Jane can be contacted via phone (770) 722-2624.

Contact Information

Primary practice address
1151 Broadway Suite 202 Sonoma CA 95476-7571
Phone: (770) 722-2624
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X PSY14649 California
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY14649 California
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X PSY14649 California
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X PSY14649 California

Profile Details

NPI number 1811047780
LBN Legal business name Wakefield, Phylis Jane
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2007
Last updated Mar 3rd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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