Provider Demographics
NPI:1962967208
Name:BAY AREA MINDS MARRIAGE AND FAMILY THERAPY, INC
Entity type:Organization
Organization Name:BAY AREA MINDS MARRIAGE AND FAMILY THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DI RIENZO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-878-9260
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-0623
Mailing Address - Country:US
Mailing Address - Phone:925-878-9260
Mailing Address - Fax:
Practice Address - Street 1:1460 MARIA LN STE 310
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8803
Practice Address - Country:US
Practice Address - Phone:925-878-9260
Practice Address - Fax:925-299-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty