Healthcare Provider Details

I. General information

NPI: 1215740337
Provider Name (Legal Business Name): FENECH ENTERPRISES, A MARRIAGE & FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SAN MARLO WAY STE 4
PACIFICA CA
94044-3274
US

IV. Provider business mailing address

44 LUPINE AVE
SAN FRANCISCO CA
94118-2721
US

V. Phone/Fax

Practice location:
  • Phone: 530-536-0563
  • Fax:
Mailing address:
  • Phone: 650-815-5071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KATE FENECH
Title or Position: CEO
Credential: LMFT#134210
Phone: 650-815-5071