Provider Demographics
NPI:1730472580
Name:B & R FAMILY THERAPY INC.
Entity Type:Organization
Organization Name:B & R FAMILY THERAPY INC.
Other - Org Name:BAKER & RICHTER PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:805-231-1331
Mailing Address - Street 1:155 GRANADA ST
Mailing Address - Street 2:SUITE N
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-7866
Mailing Address - Country:US
Mailing Address - Phone:805-231-1331
Mailing Address - Fax:805-383-1502
Practice Address - Street 1:155 GRANADA ST
Practice Address - Street 2:SUITE N
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-7866
Practice Address - Country:US
Practice Address - Phone:805-231-1331
Practice Address - Fax:805-383-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19108106H00000X
CA36547106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty