Provider Demographics
NPI:1699498600
Name:OPEN-HEARTED FAMILY THERAPY INC
Entity type:Organization
Organization Name:OPEN-HEARTED FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE&FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PALISOC
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-534-2367
Mailing Address - Street 1:10 ENSUENO E
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1844
Mailing Address - Country:US
Mailing Address - Phone:949-300-4590
Mailing Address - Fax:
Practice Address - Street 1:7545 IRVINE CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2933
Practice Address - Country:US
Practice Address - Phone:949-534-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty