Provider Demographics
NPI:1356613210
Name:ABBEYFIELD PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:ABBEYFIELD PSYCHOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMERA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEDICT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-498-5900
Mailing Address - Street 1:5479 E ABBEYFIELD ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3050
Mailing Address - Country:US
Mailing Address - Phone:562-498-5900
Mailing Address - Fax:562-498-5909
Practice Address - Street 1:5479 E ABBEYFIELD ST
Practice Address - Street 2:SUITE 3
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3050
Practice Address - Country:US
Practice Address - Phone:562-498-5900
Practice Address - Fax:562-498-5909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS195421041C0700X
CAMFC43055106H00000X
CAPSY19703103TC0700X
CALCS183601041C0700X
CALCS257751041C0700X
CAMFC46641106H00000X
CALCS214291041C0700X
CALCS27670103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty