Provider Demographics
NPI:1730570862
Name:BRANCHES BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:BRANCHES BEHAVIORAL HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:KORFIST
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:310-720-1446
Mailing Address - Street 1:41667 IVY ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-1412
Mailing Address - Country:US
Mailing Address - Phone:310-720-1446
Mailing Address - Fax:888-562-3648
Practice Address - Street 1:41667 IVY ST
Practice Address - Street 2:SUITE D
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-1412
Practice Address - Country:US
Practice Address - Phone:310-720-1446
Practice Address - Fax:888-562-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37154106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty