Healthcare Provider Details

I. General information

NPI: 1861085672
Provider Name (Legal Business Name): BAY AREA THERAPY GROUP A MARRIAGE FAMILY COUNSELING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 DIAMOND WAY STE 240
CONCORD CA
94520-5260
US

IV. Provider business mailing address

1220 DIAMOND WAY STE 240
CONCORD CA
94520-5260
US

V. Phone/Fax

Practice location:
  • Phone: 152-548-2034
  • Fax: 415-376-5899
Mailing address:
  • Phone: 415-254-8203
  • Fax: 415-576-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN CHARLES BIEDA JR.
Title or Position: CEO
Credential: MFT
Phone: 415-254-8203