Provider Demographics
NPI:1922885409
Name:EDEN BYRNE MARRIAGE & FAMILY THERAPY INC.
Entity Type:Organization
Organization Name:EDEN BYRNE MARRIAGE & FAMILY THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-419-3158
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93020-0032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:771 E DAILY DR STE 310
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-0784
Practice Address - Country:US
Practice Address - Phone:805-419-3158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty