MEDICARE: SIMI VALLEY FAMILY THERAPY INC

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	:	1356298194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMI VALLEY FAMILY THERAPY INC

Provider Business Mailing Address
First Line	:	585 E LOS ANGELES AVE STE F
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-1865
Country	:	US
Telephone Number	:	805-293-0350
Fax Number	:

Provider Business Practice Location Address
First Line	:	585 E LOS ANGELES AVE STE F
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-1865
Country	:	US
Telephone Number	:	805-293-0350
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PATRICK EASLEY
Credential	:
Telephone Number	:	805-293-0350

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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