Healthcare Provider Details
I. General information
NPI: 1629989819
Provider Name (Legal Business Name): INFINITE GROWTH CHILD AND FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
480 N CIVIC DR APT 104
WALNUT CREEK CA
94596-3342
US
IV. Provider business mailing address
480 N CIVIC DR APT 104
WALNUT CREEK CA
94596-3342
US
V. Phone/Fax
- Phone: 619-838-1599
- Fax:
- Phone: 619-838-1599
- 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:
MALIKA
MAHANNA
Title or Position: CEO
Credential: LMFT
Phone: 619-838-1599