Provider Demographics
NPI:1104387059
Name:SF BAY MARRIAGE & FAMILY THERAPIST GROUP, P.C.
Entity Type:Organization
Organization Name:SF BAY MARRIAGE & FAMILY THERAPIST GROUP, P.C.
Other - Org Name:SF BAY THERAPIST GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:650-823-4537
Mailing Address - Street 1:1525 MIRAMONTE AVE UNIT 3644
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-9025
Mailing Address - Country:US
Mailing Address - Phone:650-823-4537
Mailing Address - Fax:
Practice Address - Street 1:1307 S MARY AVE STE 250
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3071
Practice Address - Country:US
Practice Address - Phone:650-823-4537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty