Provider Demographics
NPI:1326831488
Name:ARYANA MARRIAGE AND FAMILY THERAPY WELLNESS CENTER, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ARYANA MARRIAGE AND FAMILY THERAPY WELLNESS CENTER, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LANEAL
Authorized Official - Last Name:STULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:510-395-4814
Mailing Address - Street 1:3314 WILLOWBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-1701
Mailing Address - Country:US
Mailing Address - Phone:510-488-8734
Mailing Address - Fax:866-635-2788
Practice Address - Street 1:1351 W OAK ST STE 7
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203-2641
Practice Address - Country:US
Practice Address - Phone:510-395-4814
Practice Address - Fax:866-635-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health