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General NPI Number Information
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NPI Number | 1821708694
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Entity Type | Organization
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Legal Business Name | JUDITH LUCIA I. ALBANO, A MARRIAGE AND FAMILY THERAPY CORPORATION
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 80 EUREKA SQ STE 215
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City | PACIFICA
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State | CA
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Zip | 94044-2677
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Country | US
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Telephone | 415-269-5254
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Fax | 415-480-1444
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Provider Business Mailing Address
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Address Line | 55 CHICAGO WAY
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City | SAN FRANCISCO
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State | CA
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Zip | 94112-4533
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Country | US
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Telephone | 415-533-5028
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Fax | 415-480-1444
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | JUDITH LUCIA IGNACIO ALBANO
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Credential | LMFT
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Telephone | 415-269-5254
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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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