MEDICARE: DOT CENTER - 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	:	1730701301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOT CENTER - MARRIAGE AND FAMILY THERAPY INC.

Provider Business Mailing Address
First Line	:	1624 FRANKLIN ST STE 911
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-2824
Country	:	US
Telephone Number	:	415-857-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1624 FRANKLIN ST STE 911
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-2824
Country	:	US
Telephone Number	:	415-857-5558
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	ELIZABETH TONG
Credential	:	MFT
Telephone Number	:	415-533-9901

Provider Enumeration Date	:	05/17/2020
Last Update Date	:	05/17/2020

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