=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295204451
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TESSA BARROWS, MARRIAGE & FAMILY THERAPIST, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2018
-----------------------------------------------------
Last Update Date | 12/13/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 37 QUAIL CT STE 201
-----------------------------------------------------
City | WALNUT CREEK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94596-5593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-378-2428
-----------------------------------------------------
Fax | 925-322-2517
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 322 MACALVEY DR
-----------------------------------------------------
City | MARTINEZ
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94553-6620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-999-4625
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TESSA BARROWS
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 415-999-4625
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------