Provider Demographics
NPI:1093686867
Name:BIJANA BAILLERES MARRIAGE AND FAMILY THERAPY, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:BIJANA BAILLERES MARRIAGE AND FAMILY THERAPY, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BIJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILLERES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:239-384-2826
Mailing Address - Street 1:4333 PARK TERRACE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4333 PARK TERRACE DR STE 140
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4451
Practice Address - Country:US
Practice Address - Phone:239-384-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty