Provider Demographics
NPI:1609453828
Name:GUILLAUME MARRIAGE AND FAMILY COUNSELING OF CALIFORNIA, P.C.
Entity Type:Organization
Organization Name:GUILLAUME MARRIAGE AND FAMILY COUNSELING OF CALIFORNIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAHOMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLAUME
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:503-922-3360
Mailing Address - Street 1:20333 STATE HIGHWAY 249 STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2613
Mailing Address - Country:US
Mailing Address - Phone:800-887-0316
Mailing Address - Fax:971-352-4229
Practice Address - Street 1:6203 SAN IGNACIO AVE STE 110
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1358
Practice Address - Country:US
Practice Address - Phone:916-992-2620
Practice Address - Fax:971-352-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty