Healthcare Provider Details

I. General information

NPI: 1275479206
Provider Name (Legal Business Name): WELLFUL MARRIAGE AND FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E DEL MAR BLVD STE 104
PASADENA CA
91105-2551
US

IV. Provider business mailing address

200 E DEL MAR BLVD STE 104
PASADENA CA
91105-2551
US

V. Phone/Fax

Practice location:
  • Phone: 310-734-8140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIMBERLY SLIPSKI
Title or Position: OWNER
Credential: MA
Phone: 310-734-8140