Healthcare Provider Details

I. General information

NPI: 1104730530
Provider Name (Legal Business Name): MARRIAGE AND FAMILY THERAPY WITH ANI INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 FREMONT AVE STE 105
LOS ALTOS CA
94024-5602
US

IV. Provider business mailing address

3370 LOUIS RD
PALO ALTO CA
94303-4174
US

V. Phone/Fax

Practice location:
  • Phone: 650-334-5953
  • Fax:
Mailing address:
  • Phone: 650-334-5953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. ANANDALAKSHMI GNANALINGAM
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: LMFT
Phone: 650-334-5953