MEDICARE: MARRIAGE AND FAMILY CENTER

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	MFC40911	CA

General Provider Information

NPI Number	:	1285980805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARRIAGE AND FAMILY CENTER

Provider Business Mailing Address
First Line	:	1326 H ST STE 3
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5134
Country	:	US
Telephone Number	:	661-327-5100
Fax Number	:	661-327-5101

Provider Business Practice Location Address
First Line	:	1326 H ST STE 3
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5134
Country	:	US
Telephone Number	:	661-327-5100
Fax Number	:	661-327-5101

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MICHAEL BEAN
Credential	:	LMFT
Telephone Number	:	661-327-5100

Provider Enumeration Date	:	08/01/2012
Last Update Date	:	08/01/2012

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