Provider Demographics
NPI:1194593756
Name:COMPHY COUCH MARRIAGE AND FAMILY INC.
Entity type:Organization
Organization Name:COMPHY COUCH MARRIAGE AND FAMILY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIC. MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT113438
Authorized Official - Phone:805-222-6854
Mailing Address - Street 1:1103 E CLARK AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5145
Mailing Address - Country:US
Mailing Address - Phone:805-222-6854
Mailing Address - Fax:
Practice Address - Street 1:1103 E CLARK AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5145
Practice Address - Country:US
Practice Address - Phone:805-222-6854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty