Healthcare Provider Details

I. General information

NPI: 1962311324
Provider Name (Legal Business Name): MEADOW AND VINE MARRIAGE AND FAMILY THERAPY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S FAIR OAKS AVE STE 226
PASADENA CA
91105-2083
US

IV. Provider business mailing address

107 S FAIR OAKS AVE STE 226
PASADENA CA
91105-2083
US

V. Phone/Fax

Practice location:
  • Phone: 818-208-0058
  • 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: AMY DI FRANCIA
Title or Position: OWNER
Credential: LMFT 105646
Phone: 818-208-0058