Provider Demographics
NPI:1437187457
Name:OSTROM, BRITA (MFT)
Entity Type:Individual
Prefix:MS
First Name:BRITA
Middle Name:
Last Name:OSTROM
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 355
Mailing Address - Street 2:
Mailing Address - City:BIG SUR
Mailing Address - State:CA
Mailing Address - Zip Code:93920
Mailing Address - Country:US
Mailing Address - Phone:831-625-0250
Mailing Address - Fax:
Practice Address - Street 1:MISSION ST BETWEEN 7TH & 8TH
Practice Address - Street 2:CARMEL PROF BLDG
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93921
Practice Address - Country:US
Practice Address - Phone:831-625-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28636106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist