Healthcare Provider Details
I. General information
NPI: 1932940137
Provider Name (Legal Business Name): BARRAGAN PROFESSIONAL MARRIAGE AND FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2024
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
425 PAGE MILL RD STE 200
PALO ALTO CA
94306-2075
US
IV. Provider business mailing address
425 PAGE MILL RD STE 200
PALO ALTO CA
94306-2075
US
V. Phone/Fax
- Phone: 408-766-4290
- Fax:
- Phone: 87-664-2904
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAYLOR
BARRAGAN
Title or Position: CEO, CO-OWNER
Credential: LMFT
Phone: 408-766-4290