MEDICARE: FLOURISH INDIVIDUAL COUPLE AND FAMILY THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1235075128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOURISH INDIVIDUAL COUPLE AND FAMILY THERAPY

Provider Business Mailing Address
First Line	:	3816 PETALUMA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2447
Country	:	US
Telephone Number	:	850-391-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	3816 PETALUMA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2447
Country	:	US
Telephone Number	:	850-391-8070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW JAUREQUI
Credential	:	LMFT
Telephone Number	:	850-391-8070

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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Directions to “FLOURISH INDIVIDUAL COUPLE AND FAMILY THERAPY ” Practice Location

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