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General NPI Number Information
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NPI Number | 1669913877
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Entity Type | Organization
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Legal Business Name | VALLEY FAMILY COUNSELING
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 715 N CENTRAL AVE STE 108
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City | GLENDALE
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State | CA
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Zip | 91203-1225
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Country | US
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Telephone | 626-375-7224
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Fax | 818-484-8177
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Provider Business Mailing Address
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Address Line | 715 N CENTRAL AVE STE 108
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City | GLENDALE
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State | CA
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Zip | 91203-1225
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Country | US
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Telephone | 626-375-7224
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Fax | 818-484-8177
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DIANA XIMENA CASTILLO-EDDY
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Credential | M.S., LMFT
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Telephone | 626-375-7224
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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 | 46085
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License Number State | CA
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