MEDICARE: ART OF CARE THERAPY, A MARRIAGE & FAMILY THERAPY CO.

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	:	1275303737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ART OF CARE THERAPY, A MARRIAGE & FAMILY THERAPY CO.

Provider Business Mailing Address
First Line	:	8605 SANTA MONICA BLVD # 297853
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-4109
Country	:	US
Telephone Number	:	510-717-4564
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 VILLA DR
Second Line	:
City	:	SAN PABLO
State	:	CA
Zip	:	94806-3768
Country	:	US
Telephone Number	:	510-717-4564
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	JOSHUA CRUM
Credential	:	LMFT
Telephone Number	:	510-717-4564

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	01/05/2024

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