Provider Demographics
NPI:1861085672
Name:BAY AREA THERAPY GROUP A MARRIAGE AND FAMILY COUNSELING CORP
Entity type:Organization
Organization Name:BAY AREA THERAPY GROUP A MARRIAGE AND FAMILY COUNSELING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BIEDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MFT
Authorized Official - Phone:415-254-8203
Mailing Address - Street 1:1320 WILLOW PASS RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5292
Mailing Address - Country:US
Mailing Address - Phone:415-254-8203
Mailing Address - Fax:415-576-5899
Practice Address - Street 1:1320 WILLOW PASS RD STE 600
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5292
Practice Address - Country:US
Practice Address - Phone:866-227-7715
Practice Address - Fax:415-576-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1295904100OtherNPI