Provider Demographics
NPI:1144963620
Name:ELISE TOBIN MS MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:ELISE TOBIN MS MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-237-4462
Mailing Address - Street 1:408 S MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-5342
Mailing Address - Country:US
Mailing Address - Phone:805-237-4462
Mailing Address - Fax:805-434-0343
Practice Address - Street 1:408 S MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-5342
Practice Address - Country:US
Practice Address - Phone:805-237-4462
Practice Address - Fax:805-434-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health