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General NPI Number Information
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NPI Number | 1669372298
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Entity Type | Organization
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Legal Business Name | MANGO FAMILY THERAPY INC.
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Dates
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Enumeration Date | 11/07/2026
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Last Update Date | 11/07/2026
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Provider Practice Location Address
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Address Line | 1580 W EL CAMINO REAL STE 2
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2461
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Country | US
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Telephone | 650-405-1638
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Fax |
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Provider Business Mailing Address
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Address Line | 20289 STEVENS CREEK BLVD # 1224
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City | CUPERTINO
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State | CA
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Zip | 95014-2258
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Country | US
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Telephone | 650-405-1638
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | KAPILA ETHENMOO VENKATARAMAN
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Credential |
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Telephone | 650-405-1638
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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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