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General NPI Number Information
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NPI Number | 1891386546
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Entity Type | Organization
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Legal Business Name | CHARLYN CRANE ERDEK MARRIAGE AND FAMILY THERAPY CORPORATION
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 5900 WEDGEWOOD AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-5238
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Country | US
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Telephone | 213-279-6447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10641
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City | BURBANK
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State | CA
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Zip | 91510-0641
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Country | US
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Telephone | 213-359-7053
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Fax | 213-348-6106
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | CHARLYN C ERDEK
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Credential | LMFT, ATR
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Telephone | 213-359-7053
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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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