Provider Demographics
NPI:1568286284
Name:ANNABELLE DRDA MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:ANNABELLE DRDA MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRDA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:831-708-1176
Mailing Address - Street 1:550 WATER ST STE F2
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4131
Mailing Address - Country:US
Mailing Address - Phone:831-708-1176
Mailing Address - Fax:
Practice Address - Street 1:550 WATER ST STE F2
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4131
Practice Address - Country:US
Practice Address - Phone:831-708-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-09
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty