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General NPI Number Information
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NPI Number | 1720652654
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Entity Type | Organization
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Legal Business Name | PRIDE AND GRACE FAMILY COUNSELING, INC.
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Dates
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Enumeration Date | 05/15/2021
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Last Update Date | 05/15/2021
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Provider Practice Location Address
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Address Line | 122 2ND AVE STE 212
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City | SAN MATEO
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State | CA
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Zip | 94401-3836
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Country | US
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Telephone | 650-701-3978
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6963
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City | SAN MATEO
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State | CA
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Zip | 94403-6963
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PRISCILLA CHENG
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Credential | LMFT
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Telephone | 650-701-3978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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