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General NPI Number Information
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NPI Number | 1033878616
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Entity Type | Organization
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Legal Business Name | C FOSTER, MFT, INC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 27851 BRADLEY RD STE 107
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City | MENIFEE
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State | CA
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Zip | 92586-2213
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Country | US
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Telephone | 951-405-0100
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Fax | 951-672-6313
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Provider Business Mailing Address
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Address Line | PO BOX 569
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City | MENIFEE
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State | CA
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Zip | 92586-0569
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Country | US
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Telephone | 951-405-0100
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CONCEPCION FOSTER
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Credential | MFT
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Telephone | 951-405-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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