Provider Demographics
NPI:1437646007
Name:BAY AREA MARRIAGE FAMILY & CHILD COUNSELING, INC.
Entity Type:Organization
Organization Name:BAY AREA MARRIAGE FAMILY & CHILD COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:510-612-6471
Mailing Address - Street 1:39791 PASEO PADRE PKWY STE H
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2979
Mailing Address - Country:US
Mailing Address - Phone:510-612-6471
Mailing Address - Fax:
Practice Address - Street 1:39791 PASEO PADRE PKWY STE H
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2979
Practice Address - Country:US
Practice Address - Phone:510-612-6471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43574106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty