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General NPI Number Information
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NPI Number | 1134246135
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Entity Type | Organization
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Legal Business Name | BAY AREA PSYCHOTHERAPY SERVICES
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1036 A ST # 201
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City | HAYWARD
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State | CA
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Zip | 94541-4126
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Country | US
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Telephone | 510-649-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 1036 A ST # 201
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City | HAYWARD
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State | CA
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Zip | 94541-4126
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Country | US
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Telephone | 510-649-7551
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Fax |
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Authorized Official
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Title or Position | MFT INTERN
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Name | MS. BARBARA ANN JENSEN
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Credential | MA
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Telephone | 510-649-7551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFT INTERN #43734
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License Number State | CA
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