Healthcare Provider Details

I. General information

NPI: 1144153958
Provider Name (Legal Business Name): PENINSULA CHILD AND FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 AIRPORT BLVD STE 400
BURLINGAME CA
94010-2013
US

IV. Provider business mailing address

533 AIRPORT BLVD STE 400
BURLINGAME CA
94010-2013
US

V. Phone/Fax

Practice location:
  • Phone: 650-703-3288
  • Fax:
Mailing address:
  • Phone: 650-703-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. LESLIE MARIE BAXTER
Title or Position: PRESIDENT/OWNER
Credential: LMFT
Phone: 650-703-3288