Provider Demographics
NPI:1417711813
Name:AT YOUR PACE FAMILY THERAPY, INC
Entity Type:Organization
Organization Name:AT YOUR PACE FAMILY THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-239-6749
Mailing Address - Street 1:1812 W BURBANK BLVD # 7215
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1315
Mailing Address - Country:US
Mailing Address - Phone:181-823-9674
Mailing Address - Fax:
Practice Address - Street 1:1718 HUNTINGTON DR APT 1
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4854
Practice Address - Country:US
Practice Address - Phone:818-239-6749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty