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General NPI Number Information
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NPI Number | 1437646007
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Entity Type | Organization
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Legal Business Name | BAY AREA MARRIAGE FAMILY & CHILD COUNSELING, INC.
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 39791 PASEO PADRE PKWY STE H
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City | FREMONT
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State | CA
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Zip | 94538-2979
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Country | US
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Telephone | 510-612-6471
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Fax |
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Provider Business Mailing Address
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Address Line | 39791 PASEO PADRE PKWY STE H
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City | FREMONT
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State | CA
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Zip | 94538-2979
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Country | US
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Telephone | 510-612-6471
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Fax |
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Authorized Official
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Title or Position | FOUNDER/ CEO
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Name | MS. SHALINI DAYAL
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Credential | LMFT
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Telephone | 510-612-6471
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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 | 43574
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License Number State | CA
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