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General NPI Number Information
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NPI Number | 1376942276
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Entity Type | Organization
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Legal Business Name | MARVIN JAY FIBUS, PH.D. FAMILY COUNSELING INC.
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 13949 VENTURA BLVD SUITE 210
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-3584
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Country | US
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Telephone | 818-395-2831
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Fax | 818-760-8112
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Provider Business Mailing Address
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Address Line | 11945 ADDISON ST
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-3106
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Country | US
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Telephone | 818-325-6766
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Fax | 818-760-8112
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARVIN JAY FIBUS
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Credential | PH.D.
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Telephone | 818-395-2831
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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 | MFC16267
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License Number State | CA
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