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General NPI Number Information
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NPI Number | 1578397352
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Entity Type | Organization
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Legal Business Name | THE BAY PSYCHOTHERAPY CENTER PC
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Dates
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Enumeration Date | 08/26/2024
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 10781 CALLE MAR DE MARIPOSA
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City | SAN DIEGO
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State | CA
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Zip | 92130-8656
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Country | US
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Telephone | 628-400-7434
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Fax |
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Provider Business Mailing Address
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Address Line | 548 MARKET ST # 275191
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-5401
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Country | US
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Telephone | 628-400-7434
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. AXEL VALLE ALERHAND
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Credential | PSYD
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Telephone | 628-400-7434
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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