=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376352948
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TUNE MARRIAGE & FAMILY THERAPY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2025
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19712 MACARTHUR BLVD STE 110
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92612-2407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-272-8120
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25422 TRABUCO RD STE 105-430
-----------------------------------------------------
City | LAKE FOREST
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92630-2791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-272-8120
-----------------------------------------------------
Fax | 949-739-3287
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | CARINA BIDDLE
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 949-272-8120
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------