Healthcare Provider Details

I. General information

NPI: 1154074219
Provider Name (Legal Business Name): METAPHOR THERAPY: A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2022
Last Update Date: 01/30/2022
Certification Date: 01/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 SANTA CLARA AVE # 202
ALAMEDA CA
94501-4521
US

IV. Provider business mailing address

PO BOX 6384
ALAMEDA CA
94501-8184
US

V. Phone/Fax

Practice location:
  • Phone: 510-394-4679
  • Fax:
Mailing address:
  • Phone: 510-394-4679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MACKENZIE MCGREGOR STUART
Title or Position: CEO
Credential: LMFT
Phone: 510-394-4679