MEDICARE: M-PATHY A MARRIAGE AND FAMILY THERAPY CORPORATION

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	:	1699649970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M-PATHY A MARRIAGE AND FAMILY THERAPY CORPORATION

Provider Business Mailing Address
First Line	:	700 RATTAN CT
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-7728
Country	:	US
Telephone Number	:	408-502-6863
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 RATTAN CT
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-7728
Country	:	US
Telephone Number	:	408-502-6863
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIAM Z ALI
Credential	:	LMFT
Telephone Number	:	408-502-6863

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/22/2025

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