MEDICARE: C3 MARRIAGE AND 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	:	1609768621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C3 MARRIAGE AND FAMILY THERAPY, INC.

Provider Business Mailing Address
First Line	:	1414 YELLOWSTONE AVE
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91915-1650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1414 YELLOWSTONE AVE
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91915-1650
Country	:	US
Telephone Number	:	619-356-3896
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CLAUDIA COVARRUBIAS
Credential	:
Telephone Number	:	619-356-3896

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	07/15/2025

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