Provider Demographics
NPI:1235748872
Name:TURLOCK FAMILY COUNSELING
Entity Type:Organization
Organization Name:TURLOCK FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KIRSTEN
Authorized Official - Last Name:MUNDELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-850-0844
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:DENAIR
Mailing Address - State:CA
Mailing Address - Zip Code:95316-0139
Mailing Address - Country:US
Mailing Address - Phone:209-850-0844
Mailing Address - Fax:
Practice Address - Street 1:261 N PALM ST
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4028
Practice Address - Country:US
Practice Address - Phone:209-850-0844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty