Healthcare Provider Details

I. General information

NPI: 1356440259
Provider Name (Legal Business Name): ELAINE MAUREEN BACHMANN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26465 CARMEL RANCHO BLVD SUITE 3
CARMEL CA
93923-8747
US

IV. Provider business mailing address

26465 CARMEL RANCHO BLVD SUITE 3
CARMEL CA
93923-8747
US

V. Phone/Fax

Practice location:
  • Phone: 831-625-2574
  • Fax: 831-625-2574
Mailing address:
  • Phone: 831-625-2574
  • Fax: 831-625-2574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 22063
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: