Healthcare Provider Details

I. General information

NPI: 1003663048
Provider Name (Legal Business Name): YAEL MELAMED, A MARRIAGE FAMILY THERAPY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MILLWOOD ST
MILL VALLEY CA
94941-2066
US

IV. Provider business mailing address

10 MILLWOOD ST STE 4
MILL VALLEY CA
94941-2064
US

V. Phone/Fax

Practice location:
  • Phone: 415-890-3034
  • Fax:
Mailing address:
  • Phone: 415-890-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YAEL MELAMED
Title or Position: OWNER
Credential: MFT
Phone: 415-890-3034