Provider Demographics
NPI:1891565610
Name:FAMOS THERAPIES
Entity Type:Organization
Organization Name:FAMOS THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLEN-IBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-240-2359
Mailing Address - Street 1:815 THIRD AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-1310
Mailing Address - Country:US
Mailing Address - Phone:619-500-6298
Mailing Address - Fax:
Practice Address - Street 1:815 THIRD AVE STE 311
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1310
Practice Address - Country:US
Practice Address - Phone:619-500-6298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty