Provider Demographics
NPI:1629531678
Name:MARRIAGE AND FAMILY COUNSELING CENTER, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MARRIAGE AND FAMILY COUNSELING CENTER, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:PRISCILLA
Authorized Official - Last Name:COBOS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:661-234-8158
Mailing Address - Street 1:38058 FLORAC ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3423
Mailing Address - Country:US
Mailing Address - Phone:818-389-6653
Mailing Address - Fax:
Practice Address - Street 1:1529 E PALMDALE BLVD STE 340
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2030
Practice Address - Country:US
Practice Address - Phone:661-234-8158
Practice Address - Fax:562-365-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty