Healthcare Provider Details

I. General information

NPI: 1437187457
Provider Name (Legal Business Name): BRITA OSTROM MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MISSION ST BETWEEN 7TH & 8TH CARMEL PROF BLDG
CARMEL CA
93921
US

IV. Provider business mailing address

POST OFFICE BOX 355
BIG SUR CA
93920
US

V. Phone/Fax

Practice location:
  • Phone: 831-625-0250
  • Fax:
Mailing address:
  • Phone: 831-625-0250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT28636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: