Healthcare Provider Details
I. General information
NPI: 1679482269
Provider Name (Legal Business Name): BAY FAMILY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9410 CAMERON ST
RANCHO CUCAMONGA CA
91730-5618
US
IV. Provider business mailing address
9410 CAMERON ST
RANCHO CUCAMONGA CA
91730-5618
US
V. Phone/Fax
- Phone: 443-974-5910
- Fax:
- Phone: 415-496-6568
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHENA
JENSEN
Title or Position: OWNER
Credential: LMFT
Phone: 415-496-6568