MEDICARE: BAYFRONT YOUTH AND FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1306118070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYFRONT YOUTH AND FAMILY SERVICES

Provider Business Mailing Address
First Line	:	4300 LONG BEACH BLVD STE 750
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2013
Country	:	US
Telephone Number	:	562-595-4525
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 LONG BEACH BLVD STE 750
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2013
Country	:	US
Telephone Number	:	562-595-4525
Fax Number	:

Authorized Official
Title or Position	:	CEO/EXECUTIVE DIRECTOR
Name	:	MARYAM RIBADU JENKINS
Credential	:
Telephone Number	:	562-595-8111

Provider Enumeration Date	:	01/27/2012
Last Update Date	:	03/10/2026

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Directions to “BAYFRONT YOUTH AND FAMILY SERVICES ” Practice Location

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