Healthcare Provider Details

I. General information

NPI: 1285547893
Provider Name (Legal Business Name): BAY VALLEY MARRIAGE & FAMILY COUNSELING GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 ROYAL OAKS DR
VACAVILLE CA
95687-5021
US

IV. Provider business mailing address

607 ELMIRA ROAD. BOX # 360
VACAVILLE CA
95687-4655
US

V. Phone/Fax

Practice location:
  • Phone: 530-341-3303
  • Fax:
Mailing address:
  • Phone: 530-341-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. AUSTIN BOWEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MBA, MA, AMFT, PPSC
Phone: 530-341-3303