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NPI Code Detail

MEDICARE: ANDERSON MARRIAGE AND FAMILY COUNSELING INC.

MEDICARE: ANDERSON MARRIAGE AND FAMILY COUNSELING 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1770323727
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDERSON MARRIAGE AND FAMILY COUNSELING INC.
Provider Business Mailing Address
First Line : 1470 MARIA LN STE 240
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94596-5399
Country : US
Telephone Number : 925-450-6155
Fax Number :
Provider Business Practice Location Address
First Line : 1470 MARIA LN STE 240
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94596-5399
Country : US
Telephone Number : 925-450-6155
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ERIC MYLES ANDERSON
Credential : LMFT
Telephone Number : 925-360-5207
Provider Enumeration Date : 05/28/2024
Last Update Date : 05/28/2024

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